The Effect of Systemic Chemotherapy on Survival in Patients With Localized, Regional, or Metastatic Adenocarcinoma of the Urinary Bladder.
Journal
American journal of clinical oncology
ISSN: 1537-453X
Titre abrégé: Am J Clin Oncol
Pays: United States
ID NLM: 8207754
Informations de publication
Date de publication:
08 2020
08 2020
Historique:
pubmed:
30
5
2020
medline:
30
10
2020
entrez:
30
5
2020
Statut:
ppublish
Résumé
To test the effect of systemic chemotherapy on cancer-specific mortality (CSM) in patients with adenocarcinoma of the urinary bladder (ADKUB). 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. 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). 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.
Identifiants
pubmed: 32467527
doi: 10.1097/COC.0000000000000704
pii: 00000421-202008000-00006
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
567-574Références
Moschini M, D’Andrea D, Korn S, et al. Characteristics andclinical significance of histological variants of bladder cancer. Nat Rev Urol. 2017;14:651–668.
Baumeister P, Zamboni S, Mattei A, et al. Histological variants in non-muscle invasive bladder cancer. Transl Androl Urol. 2019;8:34–38.
Manunta A, Vincendeau S, Kiriakou G, et al. Non-transitional cell bladder carcinomas. BJU Int. 2005;95:497–502.
Vetterlein MW, Seisen T, Leow JJ, et al. Effect of nonurothelial histologic variants on the outcomes of radical cystectomy for nonmetastatic muscle-invasive urinary bladder cancer. Clin Genitourin Cancer. 2018;16:e129–e139.
Lughezzani G, Sun M, Jeldres C, et al. Adenocarcinoma versus urothelial carcinoma of the urinary bladder: comparison between pathologic stage at radical cystectomy and cancer-specific mortality. Urology. 2010;75:376–381.
Zaffuto E, Gazdovich S, Leyh-Bannurah SR, et al. Contemporary rates of pathological features and mortality for adenocarcinoma of the urinary bladder in the USA. Int J Urol. 2017;24:117–123.
Witjes JA, Lebret T, Compérat EM, et al. Updated 2016 EAU Guidelines on muscle-invasive and metastatic bladder cancer. Eur Urol. 2017;71:462–475.
Flaig TW, Spiess PE, Agarwal N, et al. NCCN Guidelines Insights: Bladder Cancer, Version 5.2018. J Natl Compr Cancer Netw. 2018;16:1041–1053.
Galsky MD, Iasonos A, Mironov S, et al. Prospective trial of ifosfamide, paclitaxel, and cisplatin in patients with advanced non-transitional cell carcinoma of the urothelial tract. Urology. 2007;69:255–259.
Hong JY, Choi MK, Uhm JE, et al. Palliative chemotherapy for non-transitional cell carcinomas of the urothelial tract. Med Oncol. 2009;26:186–192.
De Santis M, Bachner M. New developments in first- and second-line chemotherapy for transitional cell, squamous cell and adenocarcinoma of the bladder. Curr Opin Urol. 2007;17:363–368.
Vetterlein MW, Wankowicz SAM, Seisen T, et al. Neoadjuvant chemotherapy prior to radical cystectomy for muscle-invasive bladder cancer with variant histology. Cancer. 2017;123:4346–4355.
Berg S, D’Andrea D, Vetterlein MW, et al. Impact of adjuvant chemotherapy in patients with adverse features and variant histology at radical cystectomy for muscle-invasive carcinoma of the bladder: does histologic subtype matter? Cancer. 2019;125:1449–1458.
Logothetis CJ, Dexeus FH, Chong C, et al. Cisplatin, cyclophosphamide and doxorubicin chemotherapy for unresectable urothelial tumors: the M.D. Anderson experience. J Urol. 1989;141:33–37.
Noone AM, Howlader N, Krapcho M, et al. Cancer Statistics Review, 1975-2015—SEER Statistics. Bethesda, MD: National Cancer Institute; 2018.
Austin PC. An introduction to propensity score methods for reducing the effects of confounding in observational studies. Multivariate Behav Res. 2011;46:399–424.
Luzzago S, Palumbo C, Rosiello G, et al. Survival of contemporary patients with non-metastatic urachal vs. non-urachal adenocarcinoma of the urinary bladder. World J Urol. 2020. Doi: 10.1007/s00345-020-03083-5.
doi: 10.1007/s00345-020-03083-5
Wright JL, Porter MP, Li CI, et al. Differences in survival among patients with urachal and nonurachal adenocarcinomas of the bladder. Cancer. 2006;107:721–728.
Dutta R, Abdelhalim A, Martin JW, et al. Effect of tumor location on survival in urinary bladder adenocarcinoma: a population-based analysis. Urol Oncol Semin Orig Investig. 2016;34:531.e1–531.e6.
Collazo-Lorduy A, Castillo-Martin M, Wang L, et al. Urachal carcinoma shares genomic alterations with colorectal carcinoma and may respond to epidermal growth factor inhibition. Eur Urol. 2016;70:771–775.
Siefker-Radtke AO, Gee J, Shen Y, et al. Multimodality management of urachal carcinoma: the M.D. Anderson Cancer Center experience. J Urol. 2003;169:1295–1298.
Seisen T, Sun M, Leow JJ, et al. Efficacy of high-intensity local treatment for metastatic urothelial carcinoma of the bladder: a propensity score-weighted analysis from the National Cancer Data Base. J Clin Oncol. 2019;34:29. Doi: 10.1200/JCO.2016.66.7352.
doi: 10.1200/JCO.2016.66.7352
Moschini M, Xylinas E, Zamboni S, et al. Efficacy of surgery in the primary tumor site for metastatic urothelial cancer: analysis of an international, multicenter, multidisciplinary database. Eur Urol Oncol. 2020;3:94–101.
Luzzago S, Palumbo C, Rosiello G, et al. The effect of radical cystectomy on survival in patients with metastatic urothelial carcinoma of the urinary bladder. J Surg Oncol. 2019;120:1266–1275.