Abstract
OUTCOMES FOR SECONDARY MUSCLE INVASIVE BLADDER CANCER: HOW FAR HAVE WE PROGRESSED?
Urologic oncology, Vol.43(3 Suppl), pp.44-45
03/2025
DOI: 10.1016/j.urolonc.2024.12.113
Abstract
Secondary muscle invasive bladder cancer (sMIBC), in which non-muscle invasive disease (NMIBC) has progressed to muscle invasion, has been associated with poor prognosis compared to primary muscle invasive disease (pMIBC). However, many reported series predate widespread adoption of neoadjuvant chemotherapy (NAC) and advances in transurethral resection techniques. Herein, we sought to evaluate temporal trends in outcomes of pMIBC versus sMIBC.
We identified patients undergoing RC for bladder cancer between 1980-2020 at our institution. Patients with sMIBC were compared to those with pMIBC. Those with sMIBC were further compared based on receipt of NAC and management prior to and after the year 2000, at which time our institution transitioned to routine use of re-staging TURBT. Cancer-specific survival (CSS) and overall survival (OS) estimates were generated using the Kaplan-Meier method and compared using the log-rank test. Cox proportional hazard regression models were used to adjust for demographics, histology, stage, use of chemotherapy, and year of RC.
A total of 2,203 patients underwent RC at our institution between 1980 and 2020, of whom 839 (38.1%) were identified as having sMIBC. Compared to patients with pMIBC, those with sMIBC had significantly lower 5-year CSS (52.6% vs 64.9%, p<0.01) and OS (43.4% vs 54.6%, p<0.01). On multivariable analysis, sMIBC remained significantly associated with decreased survival compared to pMIBC (OR 0.86, p<0.01). For patients with sMIBC, outcomes did not differ based on receipt of NAC (N=81), management prior to the year 2000 (N=341), or management after the year 2000 (N=417) with estimated 5-year CSS of 51.4% for those receiving NAC, 54.4% for those managed prior to 2000, and 54.0% for those managed after 2000 (Figure 1, p=0.92).
Treatment of sMIBC remains a challenge, with poor prognosis compared to pMIBC and no significant improvement in outcomes over time. Further work is needed to evaluate novel treatment strategies in the neoadjuvant setting and to prevent patients from progressing to this high-risk stage.
Details
- Title: Subtitle
- OUTCOMES FOR SECONDARY MUSCLE INVASIVE BLADDER CANCER: HOW FAR HAVE WE PROGRESSED?
- Creators
- Grant M HenningSpyridon BasourakosPrabin ThapaRobert TarrellJohn ChevilleVidit SharmaParas ShahR. Jeffrey KarnesStephen BoorjianIgor Frank
- Resource Type
- Abstract
- Publication Details
- Urologic oncology, Vol.43(3 Suppl), pp.44-45
- DOI
- 10.1016/j.urolonc.2024.12.113
- ISSN
- 1078-1439
- eISSN
- 1873-2496
- Publisher
- Elsevier Inc
- Number of pages
- 2
- Language
- English
- Date published
- 03/2025
- Academic Unit
- Urology
- Record Identifier
- 9984958623702771
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