Tags

Type your tag names separated by a space and hit enter

The Effect of Systemic Chemotherapy on Survival in Patients With Localized, Regional, or Metastatic Adenocarcinoma of the Urinary Bladder.
Am J Clin Oncol. 2020 Aug; 43(8):567-574.AJ

Abstract

OBJECTIVES

To test the effect of systemic chemotherapy on cancer-specific mortality (CSM) in patients with adenocarcinoma of the urinary bladder (ADKUB).

MATERIALS AND METHODS

Within the Surveillance, Epidemiology, and End Results registry (2004 to 2016), we identified patients with localized (T2-3N0M0), regional (T4N0M0/TanyN1-3M0), and metastatic (TanyNanyM1) ADKUB. Temporal trends, Kaplan-Meier plots, and multivariable Cox regression models were used before and after 1:1 propensity score matching and inverse probability of treatment weighting.

RESULTS

Of 1537 patients with ADKUB, 834 (54.0%), 363 (23.5%), and 340 (22.5%) harbored localized, regional, and metastatic disease, respectively. The rates of chemotherapy use increased in localized (estimated annual percentage change [EAPC]: +2.7%; P=0.03) and regional ADKUB (EAPC: +2.4%; P=0.04). Conversely, chemotherapy rates remained stable in metastatic patients (EAPC: +1.6%; P=0.4). In multivariable Cox regression models, chemotherapy use was associated with lower CSM in metastatic ADKUB (hazard ratio [HR]: 0.5; P=0.003), but not in either localized (HR: 0.8; P=0.2) or in regional ADKUB (HR: 1.0; P=0.9). In metastatic ADKUB, the benefit of chemotherapy on CSM persisted after 1:1 propensity score matching (HR: 0.6; P=0.002) and after inverse probability of treatment weighting (HR: 0.4; P<0.001).

CONCLUSIONS

Chemotherapy improves survival in metastatic ADKUB. However, only one out of 2 such patients benefit from chemotherapy. In consequence, greater emphasis on chemotherapy use may be warranted in these patients. Conversely, no benefit was identified in localized or regional ADKUB.

Authors+Show Affiliations

Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montreal Health Center, Montreal, QC, Canada. Department of Urology, European Institute of Oncology, IRCCS.Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montreal Health Center, Montreal, QC, Canada. Department of Medical and Surgical Specialties, Radiological Science and Public Health, Urology Unit, ASST Spedali Civili of Brescia, University of Brescia, Brescia.Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montreal Health Center, Montreal, QC, Canada. Department of Urology and Division of Experimental Oncology, URI, Urological Research Institute, IRCCS San Raffaele Scientific Institute.Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montreal Health Center, Montreal, QC, Canada. Department of Urology, San Luigi Gonzaga Hospital, University of Turin, Turin, Italy.Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montreal Health Center, Montreal, QC, Canada. Department of Urology, University Hospital Frankfurt, Frankfurt am Main, Germany.Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montreal Health Center, Montreal, QC, Canada. Department of Urology, European Institute of Oncology, IRCCS.Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montreal Health Center, Montreal, QC, Canada.Department of Urology, European Institute of Oncology, IRCCS.Department of Urology, IRCCS Fondazione Ca' Granda-Ospedale Maggiore Policlinico.Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria. Department of Urology, Weill Cornell Medical College, New York, NY. Department of Urology, University of Texas Southwestern, Dallas, TX. Department of Urology, Second Faculty of Medicine, Charles University, Prag, Czech Republicm. Institute for Urology and Reproductive Health, I.M. Sechenov First Moscow State Medical University, Moscow, Russia.Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montreal Health Center, Montreal, QC, Canada.Department of Urology and Division of Experimental Oncology, URI, Urological Research Institute, IRCCS San Raffaele Scientific Institute.Department of Urology, European Institute of Oncology, IRCCS. Department of Oncology and Hemato-Oncology, University of Milan, Milan.Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montreal Health Center, Montreal, QC, Canada.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

32467527

Citation

Luzzago, Stefano, et al. "The Effect of Systemic Chemotherapy On Survival in Patients With Localized, Regional, or Metastatic Adenocarcinoma of the Urinary Bladder." American Journal of Clinical Oncology, vol. 43, no. 8, 2020, pp. 567-574.
Luzzago S, Palumbo C, Rosiello G, et al. The Effect of Systemic Chemotherapy on Survival in Patients With Localized, Regional, or Metastatic Adenocarcinoma of the Urinary Bladder. Am J Clin Oncol. 2020;43(8):567-574.
Luzzago, S., Palumbo, C., Rosiello, G., Pecoraro, A., Deuker, M., Mistretta, F. A., Tian, Z., Musi, G., Montanari, E., Shariat, S. F., Saad, F., Briganti, A., de Cobelli, O., & Karakiewicz, P. I. (2020). The Effect of Systemic Chemotherapy on Survival in Patients With Localized, Regional, or Metastatic Adenocarcinoma of the Urinary Bladder. American Journal of Clinical Oncology, 43(8), 567-574. https://doi.org/10.1097/COC.0000000000000704
Luzzago S, et al. The Effect of Systemic Chemotherapy On Survival in Patients With Localized, Regional, or Metastatic Adenocarcinoma of the Urinary Bladder. Am J Clin Oncol. 2020;43(8):567-574. PubMed PMID: 32467527.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The Effect of Systemic Chemotherapy on Survival in Patients With Localized, Regional, or Metastatic Adenocarcinoma of the Urinary Bladder. AU - Luzzago,Stefano, AU - Palumbo,Carlotta, AU - Rosiello,Giuseppe, AU - Pecoraro,Angela, AU - Deuker,Marina, AU - Mistretta,Francesco A, AU - Tian,Zhe, AU - Musi,Gennaro, AU - Montanari,Emanuele, AU - Shariat,Shahrokh F, AU - Saad,Fred, AU - Briganti,Alberto, AU - de Cobelli,Ottavio, AU - Karakiewicz,Pierre I, PY - 2020/5/30/pubmed PY - 2020/5/30/medline PY - 2020/5/30/entrez SP - 567 EP - 574 JF - American journal of clinical oncology JO - Am. J. Clin. Oncol. VL - 43 IS - 8 N2 - OBJECTIVES: To test the effect of systemic chemotherapy on cancer-specific mortality (CSM) in patients with adenocarcinoma of the urinary bladder (ADKUB). MATERIALS AND METHODS: Within the Surveillance, Epidemiology, and End Results registry (2004 to 2016), we identified patients with localized (T2-3N0M0), regional (T4N0M0/TanyN1-3M0), and metastatic (TanyNanyM1) ADKUB. Temporal trends, Kaplan-Meier plots, and multivariable Cox regression models were used before and after 1:1 propensity score matching and inverse probability of treatment weighting. RESULTS: Of 1537 patients with ADKUB, 834 (54.0%), 363 (23.5%), and 340 (22.5%) harbored localized, regional, and metastatic disease, respectively. The rates of chemotherapy use increased in localized (estimated annual percentage change [EAPC]: +2.7%; P=0.03) and regional ADKUB (EAPC: +2.4%; P=0.04). Conversely, chemotherapy rates remained stable in metastatic patients (EAPC: +1.6%; P=0.4). In multivariable Cox regression models, chemotherapy use was associated with lower CSM in metastatic ADKUB (hazard ratio [HR]: 0.5; P=0.003), but not in either localized (HR: 0.8; P=0.2) or in regional ADKUB (HR: 1.0; P=0.9). In metastatic ADKUB, the benefit of chemotherapy on CSM persisted after 1:1 propensity score matching (HR: 0.6; P=0.002) and after inverse probability of treatment weighting (HR: 0.4; P<0.001). CONCLUSIONS: Chemotherapy improves survival in metastatic ADKUB. However, only one out of 2 such patients benefit from chemotherapy. In consequence, greater emphasis on chemotherapy use may be warranted in these patients. Conversely, no benefit was identified in localized or regional ADKUB. SN - 1537-453X UR - https://www.unboundmedicine.com/medline/citation/32467527/The_Effect_of_Systemic_Chemotherapy_on_Survival_in_Patients_With_Localized,_Regional,_or_Metastatic_Adenocarcinoma_of_the_Urinary_Bladder L2 - https://doi.org/10.1097/COC.0000000000000704 DB - PRIME DP - Unbound Medicine ER -
Try the Free App:
Prime PubMed app for iOS iPhone iPad
Prime PubMed app for Android
Prime PubMed is provided
free to individuals by:
Unbound Medicine.