Journal article
Impact of Baseline Characteristics on the Survival Benefit of High-Intensity Local Treatment in Metastatic Urothelial Carcinoma of the Bladder
European urology focus, Vol.4(4), pp.568-571
07/01/2018
DOI: 10.1016/j.euf.2016.12.003
PMID: 28753834
Abstract
A recent study reported an overall survival benefit for patients with metastatic urothelial carcinoma of the bladder (mUCB) managed with high-intensity local treatment (LT) of the primary tumor (chemotherapy plus radical cystectomy and/or radiation therapy ≥50Gy). Given the non-negligible morbidity of these procedures, adequate patient selection is crucial. Our objective was to identify patients who might benefit the most from high-intensity LT. Data for 3044 patients with mUCB at diagnosis were extracted from the National Cancer Data Base 2004–2013, and patients were categorized on the basis of treatment: high-intensity LT versus conservative LT (chemotherapy plus transurethral resection of bladder tumor and/or radiation therapy <50Gy). Multivariate Cox regression analysis predicted baseline 2-yr overall mortality (OM) risk among patients who received conservative LT. We then assessed the interaction between predicted OM risk and LT type. Compared to conservative LT, high-intensity LT yielded a higher observed OM-free survival rate among all patients with pure mUCB, irrespective of their predicted OM risk (nonsignificant interaction, p=0.7). These findings underline the need for further retrospective and prospective evaluation.
Among patients with metastatic histologically pure urothelial carcinoma of the bladder, we found an overall survival benefit of high-intensity local treatment directed at the primary tumor, regardless of predicted baseline 2-yr overall mortality risk.
Among patients with metastatic histologically pure urothelial carcinoma of the bladder, we found an overall survival benefit of high-intensity local treatment to the primary tumor, regardless of predicted baseline 2-yr overall mortality risk.
Details
- Title: Subtitle
- Impact of Baseline Characteristics on the Survival Benefit of High-Intensity Local Treatment in Metastatic Urothelial Carcinoma of the Bladder
- Creators
- Malte W. Vetterlein - Brigham and Women's HospitalPatrick Karabon - Henry Ford Health SystemDeepansh Dalela - Henry Ford Health SystemTarun Jindal - Henry Ford Health SystemAkshay Sood - Henry Ford Health SystemThomas Seisen - Henry Ford Health SystemQuoc-Dien Trinh - Brigham and Women's HospitalMani Menon - Henry Ford Health SystemFiras Abdollah - Henry Ford Health System
- Resource Type
- Journal article
- Publication Details
- European urology focus, Vol.4(4), pp.568-571
- DOI
- 10.1016/j.euf.2016.12.003
- PMID
- 28753834
- NLM abbreviation
- Eur Urol Focus
- ISSN
- 2405-4569
- eISSN
- 2405-4569
- Publisher
- Elsevier B.V
- Number of pages
- 4
- Language
- English
- Date published
- 07/01/2018
- Academic Unit
- Urology
- Record Identifier
- 9984949478602771
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