Primary Invasive versus Progressive Invasive Transitional Cell Bladder Cancer: Multicentric Study of Overall Survival Rate

Abstract

Introduction and Objective: When feasible, the treatment for all-invasive bladder cancer is radical cystectomy. The aim of the present study was to analyze the prognostic difference, disease-specific survival rate, of muscle-invasive transitional cell cancer of the bladder (TCCB) for progressive invasive TCCB. Patients and Methods: A retrospective multicentric analysis was performed studying a total of 242 patients who underwent radical cystectomy for invasive TCCB from 1993 to 2005. The patients were divided into two groups: group 1 included 57 patients with progressive invasive TCCB, and group 2 included 185 patients with primary invasive TCCB. Both groups were further divided according to the pathological findings in pT2/3 (muscle and/or perivesical fat invasion), pT4 (adjacent organs/structure invasion), N+ (positive lymphatic nodes) and M+ (distant organ metastasis). Several tests were employed for statistical analysis: χ², Mann-Whitney, Kaplan-Meier method and Wilcoxon (Breslow) method were used to compare the possible survival curve differences of groups 1 and 2. Multivariated analysis determined by proportional risk regression excluded sex, age and disease stage interferences in the final results. Results: The average time for a superficial TCCB to become muscle-invasive was 37.4 months, and the average number of transurethral resections performed in each patient was 3. The average and median global survival rates were, respectively, 96 and 88 months in group 1 and 98 and 90 months in group 2, without a statistically significant difference (p = 0.0734). The 1-year survival rate was 84.32% in group 1 and 76.54% in group 2. After 3 years of follow-up the survival rate fell to 74.50% in group 1 and to 59.05% in group 2. Finally, the 5-year survival rate was 57.94% in group 1 and 52.24% in group 2. Conclusion: In the present study, patients with primary invasive and progressive invasive TCCB showed a similar 5-year disease-specific survival rate. Pathological stage (pTN, N and M) and patient demography did not interfere with the results.

Survival after Radical Cystectomy for Bladder Cancer in Relation to Prior Non-Muscle Invasive Disease in Quebec

“…Both Ferreira et al [6] and May et al [7] showed similar outcomes of patients with progressive NMIBC and primary MIBC. The 5-year OSs rates were 57.9 and 51.4% for patients with progressive NMIBC and 52.2 and 47.1% for primary MIBC respectively.…”

“…However, the oncological outcome of de novo vs. progressive MIBC patients after RC remains inconsistent in the literature, with varying and sometimes even with contradictory results regarding survival. Several authors have reported either similar or insignificantly different and comparable survival rates between the 2 groups [4,5,6,7,8,9,10,11]. Others have reported better survival in patients who progressed after initial presentation as NMIBC [12,13,14,] while yet others have reported worse prognosis if RC is performed in patients who progress to MIBC after having NMBIC [15,16.…”

The natural history of secondary muscle-invasive bladder cancer

“…Other authors reported on similar prognosis [13,14] and even better prognosis for secondary T2 [15]. All these studies are limited by a small number of patients and by the inclusion of patients who underwent radical cystectomy only.…”

Sulforaphane Inhibits the Proliferation of the BIU87 Bladder Cancer Cell Line via IGFBP-3 Elevation

“…Thus, the expense of medication is a burden not only for patients themselves, but also for the economy and society (Montgomery et al, 2013). Despite the improvements made in surgical and chemotherapeutic modalities to combating bladder cancer, the 5-year survival rate still remains relative low due to highly invasiveness and metastasis of bladder cancer (Ferreira et al, 2007;Ge et al, 2012). Therefore, studies on novel medications and therapeutic modalities are warranted.…”