Concomitant Seminal Vesicle Invasion in pT4a Urothelial Carcinoma of the Bladder with Contiguous Prostatic Infiltration is an Adverse Prognosticator for Cancer-Specific Survival after Radical Cystectomy

2014 ◽  
Vol 21 (12) ◽  
pp. 4034-4040 ◽  
Author(s):  
Matthias May ◽  
Sabine Brookman-May ◽  
Maximilian Burger ◽  
Christian Gilfrich ◽  
Hans-Martin Fritsche ◽  
...  
Keyword(s):  
Urothelial Carcinoma ◽  
Seminal Vesicle ◽  
Radical Cystectomy ◽  
Cancer Specific Survival ◽  
Seminal Vesicle Invasion ◽  
Carcinoma Of The Bladder

Cancer-specific survival in patients with urothelial carcinoma of the bladder with recurrence after radical cystectomy: External validation of the prognostic risk stratification model.

2014 ◽  
Vol 32 (4_suppl) ◽  
pp. 325-325 ◽  
Author(s):  
Tohru Nakagawa ◽  
Haruki Kume ◽  
Atsushi Kanatani ◽  
Masaomi Ikeda ◽  
Akihiko Matsumoto ◽  
...  
Keyword(s):  
Risk Factors ◽  
Urothelial Carcinoma ◽  
Radical Cystectomy ◽  
Median Survival ◽  
Prognostic Value ◽  
Risk Group ◽  
Cancer Specific Survival ◽  
Poor Risk ◽  
Carcinoma Of The Bladder ◽  
Metastatic Sites

325 Background: Prognosis of the patients with urothelial carcinoma of the bladder (UCB) who developed recurrence after radical cystectomy (RC) is generally poor, but can be variable. We previously showed that shorter time to recurrence (TTR) after RC, presence of symptoms on recurrence, more than one metastatic sites (organs), high serum C-reactive protein (CRP) level were associated with decreased survival in those patients, and proposed a model to stratify patients into 3 separate risk groups (Nakagawa et al. J Urol. 2013; 189:1275). The aim of this study was to evaluate the prognostic value of this model in a multi-institutional cohort of patients. Methods: We identified 267 patients who experienced disease recurrence after RC for UCB from 9 academic and community hospitals. Patients were categorized into three groups based on the presence of four risk factors, TTR of <1 year, presence of symptoms on recurrence, more than one metastatic sites (organs), and CRP level of ≥0.5 mg/dl: the favourable risk group included patients with none or one of these risk factors; the intermediate risk group with 2 risk factors; and those with 3 or 4 risk factors were assigned to the poor risk group. Results: Overall, median survival time (MST) of the entire cohort was 8.3 months (95%CI, 6.4-9.1). Two hundred and nineteen patients died of their disease with a median survival of 5.9 months. In a multivariate analysis, all of the 4 risk factors were statistically significant for the cancer-specific survival. Sixty-five (27.4%), 84 (35.4%), and 88 (37.1%) patients were in the favorable, intermediate and poor risk group, respectively. Thirty patients were excluded because CRP value was not obtained. MSTs of the patients in the favorable, intermediate and poor risk group were 22.2 (95% CI 16.1-28.3), 7.6 (95% CI 6.3-9.5), and 3.6 (95% CI 2.6-4.4) months, respectively, and the difference was statistically significant (p<0.001, log-rank test). Conclusions: We confirmed the prognostic value of our previous criteria based on the four variables in patients with recurrence after RC for UCB. This criteria would help in patient counseling and clinical trial design.

Prediction of cancer-specific survival after radical cystectomy in pT4a urothelial carcinoma of the bladder: development of a tool for clinical decision-making

2015 ◽  
Vol 117 (2) ◽  
pp. 272-279 ◽  
Author(s):  
Atiqullah Aziz ◽  
Shahrokh F. Shariat ◽  
Florian Roghmann ◽  
Sabine Brookman-May ◽  
Christian G. Stief ◽  
...  
Keyword(s):  
Decision Making ◽  
Urothelial Carcinoma ◽  
Radical Cystectomy ◽  
Clinical Decision Making ◽  
Clinical Decision ◽  
Cancer Specific Survival ◽  
Carcinoma Of The Bladder

scholarly journals Prognostic value of preoperative hematologic biomarkers in urothelial carcinoma of the bladder treated with radical cystectomy: a systematic review and meta-analysis

2020 ◽  
Vol 25 (8) ◽  
pp. 1459-1474 ◽  
Author(s):  
Keiichiro Mori ◽  
Noriyoshi Miura ◽  
Hadi Mostafaei ◽  
Fahad Quhal ◽  
Reza Sari Motlagh ◽  
...  
Keyword(s):  
Systematic Review ◽  
Urothelial Carcinoma ◽  
Radical Cystectomy ◽  
Prognostic Value ◽  
Meta Analysis ◽  
Primary Data ◽  
Cochrane Library ◽  
Cancer Specific Survival ◽  
Neutrophil Lymphocyte Ratio ◽  
Carcinoma Of The Bladder

Abstract This systematic review and meta-analysis aimed to assess the prognostic value of preoperative hematologic biomarkers in patients with urothelial carcinoma of the bladder treated with radical cystectomy. PUBMED, Web of Science, Cochrane Library, and Scopus databases were searched in September 2019 according to the Preferred Reporting Items for Systematic Review and Meta-analysis statement. Studies were deemed eligible if they compared cancer-specific survival in patients with urothelial carcinoma of the bladder with and without pretreatment laboratoryabnormalities. Formal meta-analyses were performed for this outcome. The systematic review identified 36 studies with 23,632 patients, of these, 32 studies with 22,224 patients were eligible for the meta-analysis. Several preoperative hematologic biomarkers were significantly associated with cancer-specific survival as follows: neutrophil − lymphocyte ratio (pooled hazard ratio [HR]: 1.20, 95% confidence interval [CI]: 1.11–1.29), hemoglobin (pooled HR: 0.87, 95% CI 0.82–0.94), C-reactive protein (pooled HR: 1.44, 95% CI 1.26–1.66), De Ritis ratio (pooled HR: 2.18, 95% CI 1.37–3.48), white blood cell count (pooled HR: 1.05, 95% CI 1.02–1.07), and albumin-globulin ratio (pooled HR: 0.26, 95% CI 0.14–0.48). Several pretreatment laboratory abnormalities in patients with urothelial carcinoma of the bladder were associated with cancer-specific mortality. Therefore, it might be useful to incorporate such hematologic biomarkers into prognostic tools for urothelial carcinoma of the bladder. However, given the study limitations including heterogeneity and retrospective nature of the primary data, the conclusions should be interpreted with caution.

scholarly journals Benefit of Adjuvant Chemotherapy After Radical Cystectomy for Treatment of Urothelial Carcinoma of the Bladder in the Elderly –An International Multicenter Study

2021 ◽  
pp. 1-13
Author(s):  
Victor M. Schuettfort ◽  
Benjamin Pradere ◽  
Hadi Mostafaei ◽  
Ekaterina Laukhtina ◽  
Keiichiro Mor ◽  
...  
Keyword(s):  
Adjuvant Chemotherapy ◽  
Elderly Patients ◽  
Urothelial Carcinoma ◽  
Radical Cystectomy ◽  
Cox Regression ◽  
Cox Model ◽  
Clinical Importance ◽  
Cancer Specific Survival ◽  
Pathologic Features ◽  
Carcinoma Of The Bladder

BACKGROUND: Radical cystectomy (RC) is the standard treatment for muscle invasive bladder cancer, but approximately half of all patients will ultimately succumb to disease progression despite apparent cure with extirpative surgery. Elderly patients are at especially high risk of advanced disease and may benefit from perioperative systemic therapy. OBJECTIVE: To assess the real-world benefit of adjuvant chemotherapy (AC) in patients ≥75 years old. METHODS: We retrospectively reviewed patients who underwent RC for non-metastatic urothelial carcinoma of the bladder (UCB) from 12 participating international medical institutions. Kaplan-Meier survival curves and Cox regression models were used to assess the association between age groups, administration of AC and oncological outcome parameters such as recurrence-free survival (RFS), cancer-specific survival (CSS) and overall survival (OS). RESULTS: 4,335 patients were included in the analyses, of which 820 (18.9%) were ≥75 years old. These elderly patients had a higher rate of adverse pathologic features. In an univariable subgroup analysis in patients ≥75 years with lymph node metastasis, 5-year OS was significantly higher in patients who had received AC (41% vs. 30.9%, p = 0.02). In a multivariable Cox model that was adjusted for several established outcome predictors, there was a significant favorable association between the administration of AC in elderly patients and OS, but no RFS or CSS. CONCLUSIONS: In this large observational study, the administration of AC was associated with improved OS, but not RFS or CSS, in elderly patients treated with RC for UCB. This is of clinical importance, as elderly patients are more likely to have adverse pathologic features and experience worse survival outcomes. Treatment of UCB should include both a multidisciplinary approach and a geriatric evaluation to identify patients who are most likely to tolerate and benefit from AC.

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