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Comparing Long-Term Survival Outcomes for Muscle-Invasive Bladder Cancer Patients Who Underwent with Radical Cystectomy and Bladder-Sparing Trimodality Therapy: A Multicentre Cohort Analysis.

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机构： [1]Department of Oncology and Hematology, The Affiliated Suzhou Science and Technology Town Hospital of Nanjing Medical University, Suzhou 215153, China. [2]Department of Epidemiology, School of Public Health, Soochow University, Suzhou 215123, China. [3]VIP Department, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China. [4]Department for Communicable Disease Control and Prevention, Suzhou Wuzhong Center for Disease Prevention and Control, Suzhou 215128, China. [5]Department of General Surgery, Harrison International Peace Hospital, Hengshui 053000, China. [6]Medical Research Centre, Beijing Chao-Yang Hospital, Capital Medical University, Beijing 100020, China. [7]Department of Radiation Oncology, Sichuan Cancer Hospital/Institute, University of Electronic Science and Technology of China, 610041 Chengdu, China. [8]Centre of Systems Medicine, Chinese Academy of Medical Sciences, Beijing 100730, China. [9]Suzhou Institute of Systems Medicine, Suzhou 215123, China. [10]Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, Suzhou 215123, China.

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Although radical cystectomy (RC) is the clinical practice guideline-recommended treatment of muscle-invasive bladder cancer (MIBC), bladder-sparing trimodality therapy (TMT) has emerged as a valid treatment option. Findings comparing the survival outcomes for MIBC patients who underwent RC and TMT are inconclusive.We designed a large hospital-based multicohort study to compare the effectiveness of TMT with RC.Information on deaths was jointly retrieved from EMR (electronic medical record), cause of death registry, and chronic disease surveillance as well as study-specific questionnaire. To avoid the systematical difference between patients who received two modalities, RC-MIBC cohort was propensity score-matched to TMT-MIBC cohort, and the Cox proportional hazard regression was used to calculate the overall survival (OS) and disease-specific survival (DSS).There were 891 MIBC patients treated with RC and another 891 MIBC patients who underwent with TMT in the propensity score matching. Comparable effectiveness between two modalities was observed for DSS (HR, 1.20; 95% confidence interval (CI), 0.94 to 1.49) and OS (HR, 1.17; 95% CI, 0.91 to 1.43) according to multiple adjustment after a median follow-up of approximately 9.3 years. However, a relatively higher mortality rate around 5 years after TMT treatment was found compared to RC (HR, 1.26; 95% CI, 1.01 to 1.53). The respective 5-year OS rates were 69% and 73% for TMT cohort and RC cohort, respectively.Our findings supported that MIBC patients with TMT yielded survival outcomes comparable to MIBC patients who underwent RC overall. Treatment options should be suggested considering patients' age and willingness.Copyright © 2022 Junlan Qiu et al.

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大类 | 3 区医学

小类 | 4 区肿瘤学

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影响因子： 0 最新[2023版] 0 最新五年平均 4.501 出版当年[2021版] 0 出版当年五年平均 4.501 出版前一年[2021版]

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第一作者机构： [1]Department of Oncology and Hematology, The Affiliated Suzhou Science and Technology Town Hospital of Nanjing Medical University, Suzhou 215153, China.

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通讯机构： [2]Department of Epidemiology, School of Public Health, Soochow University, Suzhou 215123, China. [10]Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, Suzhou 215123, China.

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