Systematic Review of Factors Associated with the Utilization of Radical Cystectomy for Bladder Cancer

Williams, Stephen B.; Hudgins, Hogan K.; Ray-Zack, Mohamed D.; Chamie, Karim; Smaldone, Marc C.; Boorjian, Stephen A.; Daneshmand, Siamak; Black, Peter C.; Kamat, Ashish M.; Goebell, Peter J.; Seiler, Roland; Schmitz‐Dräger, Bernd J.; Nawroth, Roman; Baillargeon, Jacques; Klaassen, Zachary; Kulkarni, Girish S.; Kim, Simon P.; Lee, Eugene K.; Holzbeierlein, Jeffrey M.; Hollenbeck, Brent K.; Gore, John L.

doi:10.1016/j.euo.2018.07.006

Cited by 20 publications

(12 citation statements)

References 24 publications

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“…Conversely, T3‐4 stage and node‐positive disease achieved independent predictor status of higher RC with chemotherapy rates. Some findings are consistent with previous reports that focused on patients with nonmetastatic muscle‐invasive UCUB, where older age, African American race and unmarried status were associated with lower RC use . However, other findings are inconsistent with previous reports on nonmetastatic patients, where higher tumor stage represented an independent predictor of lower RC use …”

Section: Discussionsupporting

confidence: 70%

The effect of radical cystectomy on survival in patients with metastatic urothelial carcinoma of the urinary bladder

Luzzago

Palumbo

Rosiello

et al. 2019

Journal of Surgical Oncology

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Background:To test the effect of radical cystectomy (RC) with chemotherapy vs only chemotherapy on overall mortality (OM) in metastatic urothelial carcinoma of the urinary bladder (mUCUB).Methods: Within the Surveillance, Epidemiology, and End Results registry (2004)(2005)(2006)(2007)(2008)(2009)(2010)(2011)(2012)(2013)(2014)(2015)(2016), we identified patients with mUCUB. Stratification was made according to treatment: RC with chemotherapy vs only chemotherapy. Kaplan-Meier plots and multivariable Cox regression models were used before and after 1:1 propensity score (PS) matching and inverse probability of treatment weighting (IPTW).Results: Of 2414 patients with mUCUB, 500 (21.0%) vs 1914 (79.0%) were treated with RC with chemotherapy vs only chemotherapy, respectively. In multivariable Cox regression models, RC with chemotherapy was associated with lower OM in the overall cohort (hazard ratio [HR], 0.5; P < .001), after 1:1 PS matching (HR, 0.5; P < .001), after IPTW (HR, 0.5; P < .001) and after accounting for number and location of metastases (HR, 0.5; P < .001). However, higher overall survival after RC with chemotherapy was only observed in patients with one metastatic site (21 vs 16 months; P = .001). Conclusion:In contemporary patients with mUCUB, RC with chemotherapy is associated with lower OM rates, relative to chemotherapy alone, but only in patients with a single metastatic site. These individuals accounted for the vast majority of patients in whom an RC was performed, despite the presence of metastatic disease. K E Y W O R D S chemotherapy, metastatic urothelial carcinoma of the urinary bladder, radical cystectomy

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Section: Discussionsupporting

confidence: 70%

The effect of radical cystectomy on survival in patients with metastatic urothelial carcinoma of the urinary bladder

Luzzago

Palumbo

Rosiello

et al. 2019

Journal of Surgical Oncology

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“…Importantly, approximately half of patients in the U.S. (3,15) with non-metastatic MIBC do not receive any treatment with curative intent. In a systematic review by Williams and colleagues [2019], RC was used as a mode of therapy in 6% of patients across all age groups and 19-21% among patients who were 66 years old or younger (5). An important initiative moving forward will be increase the number of patients receiving treatment with curative intent, whether it be TMT or RC (15).…”

Section: Indications For Rcmentioning

confidence: 99%

“…Radical cystectomy (RC) plays a central role in the treatment of UCB (3). It is a mainstay in the management of MIBC, together with peri-operative chemotherapy and appropriate lymphadenectomy, but is also important for the treatment of very high risk and treatment-refractory NMIBC (5)(6)(7). RC is one of the most challenging surgical techniques in Urology.…”

Section: Introductionmentioning

confidence: 99%

Radical cystectomy: a review of techniques, developments and controversies

Aminoltejari

Black

2020

Transl Androl Urol

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Radical cystectomy (RC) with urinary diversion is considered the standard treatment for muscle invasive bladder cancer (MIBC). As one of the most challenging surgical techniques performed by urologists, RC was described many decades ago, and yet patient morbidity rates have remained stagnant over the years.This review outlines the most recent indications and techniques for RC and analyses the current landscape of complications after cystectomy. There is significant room for improvement with respect to both oncologic and functional outcomes after RC. Future efforts will need to focus on unifying reporting methodology, optimal patient selection criteria, enhanced surgical techniques and peri-operative care pathways, and technological advances to improve patient outcomes.

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“…In addition to a delay between the first symptoms and a BC diagnosis, there are several mechanisms by which radical definitive treatment may be delayed for BC patients (9). Patients may not be fit enough for immediate surgery and so require treatment of comorbidities, or may be referred from primary care physicians or urology units to different hospitals for surgery (10).…”

Section: Introductionmentioning

confidence: 99%

A Systematic Review and Meta-analysis of Delay in Radical Cystectomy and the Effect on Survival in Bladder Cancer Patients

Russell

Liedberg

Khan

et al. 2020

European Urology Oncology

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Systematic Review of Factors Associated with the Utilization of Radical Cystectomy for Bladder Cancer

Cited by 20 publications

References 24 publications

The effect of radical cystectomy on survival in patients with metastatic urothelial carcinoma of the urinary bladder

The effect of radical cystectomy on survival in patients with metastatic urothelial carcinoma of the urinary bladder

Radical cystectomy: a review of techniques, developments and controversies

A Systematic Review and Meta-analysis of Delay in Radical Cystectomy and the Effect on Survival in Bladder Cancer Patients

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