Relationship of the Number of Removed Lymph Nodes to Bladder Cancer and Competing Mortality After Radical Cystectomy

Froehner, Michael; Heberling, Ulrike; Rutsch, Lydia; Litz, R. J.; Hübler, Matthias; Koch, Rainer; Baretton, Gustavo; Wirth, Manfred P.

doi:10.1016/j.eururo.2014.07.046

Cited by 37 publications

(30 citation statements)

References 9 publications

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“…With more patients available for analysis, the current study stabilized the results of earlier analyses, that is, the association of the number of removed lymph nodes (stratified by the median) with overall, competing but not with bladder cancer-specific mortality [15], the association of adjuvant cisplatin-based chemotherapy with overall, disease-specific but not with competing mortality [16] now reaching the significance level for the latter endpoint and the association of current smoking with competing but not bladder cancer-specific and overall mortality [17] (data shown in Table 2). Since most fatal second cancers in this study (Table 1) are known to be associated with smoking [18], the differing prevalence of smoking among females and males (Table 1) might explain the trend toward lower mortality from second cancers in females in this study.…”

Section: Gender and Mortality After Radical Cystectomysupporting

confidence: 62%

Gender and Mortality after Radical Cystectomy: Competing Risk Analysis

Heberling

Koch

Hübler³

et al. 2018

Urol Int

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Background: Data on the impact of gender on mortality after radical cystectomy is conflicting. We investigated a large single center sample with long-term follow-up in order to determine the relationship between gender and outcome. Patients and Methods: A total of 1,184 consecutive patients who underwent radical cystectomy for high risk superficial or muscle-invasive urothelial or undifferentiated bladder cancer between 1993 and 2015 were stratified by gender. Demographic data was compared using Mann-Whitney U test, chi-square test, or Fisher exact test. Cox proportional hazard models were used for the analysis of competing risks and logit models were used for the prediction of the receipt of adjuvant cisplatin-based chemotherapy. Results: Female patients were older, healthier, less frequently current smokers and had more extravesical tumors. In the multivariate analyses, female gender was an independent predictor of (lower) non-bladder cancer (competing) mortality (hazards ratio [HR] 0.68, 95% CI 0.49–0.95, p = 0.0248) but no predictor of bladder cancer-specific mortality (HR in the full model 1.20, 95% CI 0.94–1.54, p = 0.15). Gender was no predictor of the receipt of adjuvant cisplatin-based chemotherapy. Conclusions: Female gender was associated with an increased risk of extravesical disease but was no independent predictor of bladder cancer-specific mortality. Anatomical differences might be a plausible explanation for these observations.

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Section: Gender and Mortality After Radical Cystectomysupporting

confidence: 62%

Gender and Mortality after Radical Cystectomy: Competing Risk Analysis

Heberling

Koch

Hübler³

et al. 2018

Urol Int

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“…Though controversial and the subjective of a current randomized controlled trial, higher LN yield has been shown to improve cancer-specific mortality in radical cystectomy [13,14]. We corroborated this finding with our survival analysis (Fig.…”

Section: Oncologic Quality Indicators and Outcomessupporting

confidence: 93%

National comparison of oncologic quality indicators between open and robotic-assisted radical cystectomy

Matulewicz

DeLancey

Manjunath

et al. 2016

Urologic Oncology: Seminars and Original Investigations

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“…17 Finally, specifics regarding surgery such as anatomical extent of pelvic lymph node dissection are not captured in SEER which is an important determinant regarding surgical quality. 18 …”

Section: Discussionmentioning

confidence: 99%

Population-based assessment of racial/ethnic differences in utilization of radical cystectomy for patients diagnosed with bladder cancer

Williams

Huo

Kosarek

et al. 2017

Cancer Causes Control

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Purpose Radical cystectomy is a surgical treatment for recurrent non-muscle invasive and muscle-invasive bladder cancer, however, many patients may not receive this treatment. Methods A total of 27,578 patients diagnosed with clinical stage I to IV bladder cancer from January 1, 2007 to December 31, 2013 were identified from the Surveillance, Epidemiology, and End Results (SEER) registry database. We used multivariable regression analyses to identify factors predicting use of radical cystectomy and pelvic lymph node dissection. Cox proportional hazards models were used to analyze survival outcomes. Results A total of 1,693 (6.1%) patients with bladder cancer underwent radical cystectomy. Most patients (92.4%) who underwent radical cystectomy also underwent pelvic lymph node dissection. When compared with white patients, non-Hispanic blacks were less likely to undergo a radical cystectomy (odds ratio [OR] 0.79, 95% confidence interval [CI] 0.64–0.96, p = 0.019). Moreover, recent year of surgery 2013 vs. 2007 (OR 2.32, 95% CI 1.90–2.83, p < 0.001), greater percentage of college education ≥ 36.3% vs. <21.3% (OR 1.23, 95% CI 1.04–1.44, p =0.013), Midwest vs. West (OR 1.64, 95% CI 1.39–1.94, p<0.001) and more advanced clinical stage III vs. I (OR 29.1, 95% CI 23.9–35.3, p<0.001) was associated with increased use of radical cystectomy. Overall survival was improved for patients who underwent radical cystectomy compared with those who did not undergo a radical cystectomy (hazard ratio 0.88, 95% CI 0.80–0.97, p = 0.008). Conclusion There is significant underutilization of radical cystectomy in patients across all age groups diagnosed with bladder cancer, especially among older, non-Hispanic black patients.

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Relationship of the Number of Removed Lymph Nodes to Bladder Cancer and Competing Mortality After Radical Cystectomy

Cited by 37 publications

References 9 publications

Gender and Mortality after Radical Cystectomy: Competing Risk Analysis

Gender and Mortality after Radical Cystectomy: Competing Risk Analysis

National comparison of oncologic quality indicators between open and robotic-assisted radical cystectomy

Population-based assessment of racial/ethnic differences in utilization of radical cystectomy for patients diagnosed with bladder cancer

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