Outcome of Patients with Pathological Tumor Stage T3 Urothelial Carcinoma of the Bladder following Radical Cystectomy in a Single-Center Series with 116 Patients

Breyer, Johannes; Denzinger, Stefan; Otto, Wolfgang; Bründl, Johannes; Gierth, Michael; Fritsche, Hans‐Martin; Rößler, Wolfgang; Giedl, Christian; Hofstädter, Ferdinand; Rubenwolf, Peter; Burger, Maximilian; Aziz, Atiqullah

doi:10.1159/000360483

Cited by 9 publications

(6 citation statements)

References 26 publications

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“…Taken together, the data suggest that - if managed by radical cystectomy - women with invasive bladder cancer have a similar survival as men if matched according to the tumour stage [18]. In non-stage-matched cohorts, the poorer survival of women is most likely driven by the more advanced stages in women.…”

Section: Discussionmentioning

confidence: 99%

Sex Differences of ≥pT1 Bladder Cancer Survival in Austria: A Descriptive, Long-Term, Nation-Wide Analysis Based on 27,773 Patients

Waldhoer¹,

Berger²,

Haidinger³

et al. 2015

Urol Int

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Introduction: In recent days, the relationship between gender, tumour stage and survival of bladder cancer has attracted interest. Materials and Methods: The Austrian cancer registry was linked to the national death statistics. All patients with urothelial cancer of the urinary bladder with stages pT1, pT2, pT3 and pT4 diagnosed between 1983 until 2012 were followed for up to 15 years. Overall and cancer-specific mortality were estimated by cumulative incidence. Results: A total of 27,773 patients were analysed. The male:female ratio declined from 3:1 for stage pT1-tumours (n = 16,416) to 2.6:1 for pT2 (n = 6,548), 2.1:1 for pT3 (n = 3,111) and 1.9:1 for pT4 (n = 1,698). The 5 years cumulative overall death rate for pT1 tumours was slightly lower for women (0.31 vs. 0.32; p = 0.016). The opposite was observed for more advanced tumour stages: pT2: women 0.66, men: 0.60 (p = 0.0001); pT3: women 0.76, men 0.72 (p = 0.0004) and for pT4: women 0.90, men 0.85 (p = 0.0001). Cancer-specific survival was identical for pT1-tumours in both sexes, while women had a worse cancer-specific survival in both age cohorts (<70 years and ≥70 years) with higher tumour stages. Conclusions: This population-based study demonstrates that (1) a rise of advanced bladder cancer stages in women and (2) that women with tumour stages >pT1 have a shorter cancer-specific and overall survival.

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Section: Discussionmentioning

confidence: 99%

Sex Differences of ≥pT1 Bladder Cancer Survival in Austria: A Descriptive, Long-Term, Nation-Wide Analysis Based on 27,773 Patients

Waldhoer¹,

Berger²,

Haidinger³

et al. 2015

Urol Int

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“…Stage, grade and nodal status are proved as the most significant predictors of OS with hazard ratio exceeding 2 [ 9 ]. Other potential factors include: neoadjuvant chemotherapy [ 9 ], smoking habits [ 9 ], general condition status [ 10 ], age [ 11 ], American Society of Anesthesiologists score [ 12 ], Eastern Cooperative Oncology Group score, Elixhauser index [ 13 ] or delay time from first symptoms to surgery [ 14 ].…”

Section: Introductionmentioning

confidence: 99%

Impact of stage and comorbidities on five-year survival after radical cystectomy in Poland: single centre experience

Dybowski¹,

Ossoliński²,

Ossolińska³

et al. 2015

CEJU

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IntroductionLong-term outcomes of patients treated for invasive bladder cancer in Poland are poorly documented in the literature. Impact of various clinical parameters on their survival is even less well studied. Radical cystectomy is a major surgery, so the patients’ condition can be equally important as cancer stage. The aim of the study was to assess 5-year overall survival (OS) after cystectomy and impact of comorbidity on OS in a single Polish academic centre.Material and methodsClinical data of all patients who underwent cystectomy in years 2004-2006 for urothelial cancer were retrospectively reviewed. Survival status was determined at least 5 years after surgery. Pathological variables, comorbidities, surgery delay and complications were evaluated as potential predictors of OS. Kaplan-Meier estimates of the survival function as well as Cox proportional hazards models were utilized.ResultsThirty-day, 1-year and 5-year OS for 63 patients was 98.4%, 58.7% and 31.7%, respectively. None of the investigated parameters were significantly related to five-year OS. However, a composite parameter consisting of stage, diabetes status and postoperative course was found as a significant predictor. Five-year OS in 16 patients with pT1-2 and without diabetes and without post-operative complications was higher than in the remaining 47 patients (56% vs. 23%; P = 0.02).ConclusionsFive-year OS in our group was lower than in most published international series but concordant with a previous Polish report. Improvement in survival after radical cystectomy may be expected when early diagnosis will be accompanied by optimal care of patients with diabetes mellitus and avoidance of postoperative complications.

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“…However, only 14% were considered significantly defined as extraprostatic disease and/or pathological Gleason score ≥ 7. Previous investigators reported incidental PCa involvement in BCa patients treated with RCP of 3-50% [11][12][13][14][15][16][17] . Interestingly, we recorded an increasing rate of PCa over the years.…”

Section: Discussionmentioning

confidence: 97%

Impact of Prostate Involvement on Outcomes in Patients Treated with Radical Cystoprostatectomy for Bladder Cancer

Moschini

Shariat²,

Freschi

et al. 2017

Urol Int

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Objective: The study aimed to evaluate the impact of the different types of prostate involvement at the time of radical cystoprostatectomy (RCP). Methods: Data from 893 male patients treated with RCP at a referral center for bladder cancer (BCa) were assessed. Prostatic urothelial carcinoma (PUC) was stratified as stromal vs. urethral/duct involvements. Multivariable Cox regression analyses were built to test the impact of the presence of incidental prostate cancer (PCa) and PUC on survival outcomes. Results: PCa was present in 319 (35.7%) RCP patients, of which 45 (14.1%) had significant PCa disease. PUC was identified in 181 patients (20%): 75 (41.1%) with urethral/duct involvement and 106 (58.6%) with stromal. Within a median follow-up of 72 months, stromal PUC, but not the other forms of PUC or PCa, was associated with worse survival outcomes. In multivariable analyses adjusted for the effects of standard features, stromal PUC remained associated with recurrence (hazards ratio [HR] 2.01, p = 0.03), cancer-specific mortality (HR 1.65, p = 0.01), and overall mortality (HR 1.45, p = 0.03). Conclusion: Prostatic stromal invasion with urothelial carcinoma confers a poor survival expectation to BCa patients after surgical treatment. Conversely, other type of urothelial prostatic invasions or the presence of concomitant PCa does not seem to be associated with differences in survival outcomes.

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Outcome of Patients with Pathological Tumor Stage T3 Urothelial Carcinoma of the Bladder following Radical Cystectomy in a Single-Center Series with 116 Patients

Cited by 9 publications

References 26 publications

Sex Differences of ≥pT1 Bladder Cancer Survival in Austria: A Descriptive, Long-Term, Nation-Wide Analysis Based on 27,773 Patients

Sex Differences of ≥pT1 Bladder Cancer Survival in Austria: A Descriptive, Long-Term, Nation-Wide Analysis Based on 27,773 Patients

Impact of stage and comorbidities on five-year survival after radical cystectomy in Poland: single centre experience

Impact of Prostate Involvement on Outcomes in Patients Treated with Radical Cystoprostatectomy for Bladder Cancer

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