306 Background: The chemotherapy regimens for metastatic bladder cancer (MBC) have evolved over the last two decades. Due to favorable toxicity profile, a combination of cisplatin and gemcitabine is widely used for the treatment of MBC since 2000. It is unclear if the survival trend in MBC has changed over last two decades. This study was conducted to evaluate the relative survival rates for patients with MBC in the United States during 1991-1999 and 2000-2008. Methods: We used the Surveillance, Epidemiology, and End Results (SEER*Stat) program to analyze 6-month and 12-month relative survival rates of AJCC stage-IV bladder cancer patients included in the SEER database. We used Z-test in the SEER*Stat program to compare relative survival rates among cohorts of patients categorized by race, gender, and age groups (<60 and ≥60 years). Results: The dataset comprised 9,819 and 986 patients with AJCC stage-IV bladder cancer among Caucasians and African Americans (AA), respectively. Among Caucasian men (<60 years), 6-month survival rates were 85.4±1.7% (n=442) and 77.9±1.3% (n=1,117) for 1991-1999 and 2000-2008, respectively. Similarly, 12-month survival rates in this group were 68.6±2.2% (n=442) and 60.4±1.5% (n=1,117) for 1991-1999 and 2000-2008, respectively. Thus, both 6-month and 12-month survival rates in 2000-2008 were lower among young Caucasians; and the differences were statistically significant when compared to 1991-1999 (6-month: Z-value = -3.205, p=0.001; 12-month: Z-value= -2.984, p=0.003). The survival rates among AA were not statistically significant. Conclusions: In young Caucasian patients (<60 years) with MBC, 6- month and 12-month relative survival rates were lower for the period 2000-2008 compared to 1991-1999. Further studies may be required to evaluate factors responsible for decreased survival rates among this population.
Real-World Effectiveness of Chemotherapy in Elderly Patients With Metastatic Bladder Cancer in the United States
