TY - JOUR
T1 - Radical cystectomy for patients with pT4 urothelial carcinoma in a large population-based study
AU - Liberman, Daniel
AU - Alasker, Ahmed
AU - Sun, Maxine
AU - Ismail, Salima
AU - Lughezzani, Giovanni
AU - Jeldres, Claudio
AU - Budaus, Lars
AU - Thuret, Rodolphe
AU - Shariat, Shahrokh F.
AU - Widmer, Hugues
AU - Perrotte, Paul
AU - Graefen, Markus
AU - Montorsi, Francesco
AU - Karakiewicz, Pierre I.
PY - 2011/3
Y1 - 2011/3
N2 - OBJECTIVE: To examine cancer-specific mortality (CSM) in patients with pT4N0-3M0 urothelial carcinoma of the urinary bladder (UCUB) and to compare it to patients with pT3N0-3M0, in a population-based cohort treated with radical cystectomy (RC). PATIENTS AND METHODS: RCs were performed in 5625 pT3-T4bN0-3M0 patients with UCUB within 17 Surveillance, Epidemiology and End Results (SEER) registries between 1988 and 2006. • Univariable and multivariable models tested the effect of pT4a vs pT4b vs pT3 stages on CSM. • Covariates consisted of age, gender, race, lymph node status and SEER registries. • All analyses were repeated in 3635 pN0 patients. RESULTS: Of 5625 patients, 2043 (36.3%) had pT4aN0-3, 248 (4.4%) had pT4bN 0-3 and 3334 had pT3N0-3 (59.3%) UCUB. • The 5-year CSM was 57.6% vs 81.7% vs 53.9% for, respectively, pT4aN0-3 vs pT4bN0-3 vs pT3N0-3 patients (all log-rank P = 0.008). • In multivariable analyses the rate of CSM was 2.3-fold higher in pT4b vs pT3 (P < 0.001), 1.1-fold higher in pT4a vs pT3 (P = 0.002) and 2.0-fold higher in pT4a vs pT4b patients. • After restriction to pN0 stage, pT4b patients had a 2.3-fold higher rate of CSM than pT3 patients (P < 0.001) and pT4b patients had a 2.1-fold higher rate of CSM than pT4a patients (P < 0.001). • The CSM rate was the same for pT4a and pT3 patients (P = 0.1). CONCLUSIONS: Our findings indicate that patients with pT4a UCUB have similar CSM as those with pT3 UCUB. • Consequently, RC should be given equal consideration in patients with pT3 and pT4a UCUB.
AB - OBJECTIVE: To examine cancer-specific mortality (CSM) in patients with pT4N0-3M0 urothelial carcinoma of the urinary bladder (UCUB) and to compare it to patients with pT3N0-3M0, in a population-based cohort treated with radical cystectomy (RC). PATIENTS AND METHODS: RCs were performed in 5625 pT3-T4bN0-3M0 patients with UCUB within 17 Surveillance, Epidemiology and End Results (SEER) registries between 1988 and 2006. • Univariable and multivariable models tested the effect of pT4a vs pT4b vs pT3 stages on CSM. • Covariates consisted of age, gender, race, lymph node status and SEER registries. • All analyses were repeated in 3635 pN0 patients. RESULTS: Of 5625 patients, 2043 (36.3%) had pT4aN0-3, 248 (4.4%) had pT4bN 0-3 and 3334 had pT3N0-3 (59.3%) UCUB. • The 5-year CSM was 57.6% vs 81.7% vs 53.9% for, respectively, pT4aN0-3 vs pT4bN0-3 vs pT3N0-3 patients (all log-rank P = 0.008). • In multivariable analyses the rate of CSM was 2.3-fold higher in pT4b vs pT3 (P < 0.001), 1.1-fold higher in pT4a vs pT3 (P = 0.002) and 2.0-fold higher in pT4a vs pT4b patients. • After restriction to pN0 stage, pT4b patients had a 2.3-fold higher rate of CSM than pT3 patients (P < 0.001) and pT4b patients had a 2.1-fold higher rate of CSM than pT4a patients (P < 0.001). • The CSM rate was the same for pT4a and pT3 patients (P = 0.1). CONCLUSIONS: Our findings indicate that patients with pT4a UCUB have similar CSM as those with pT3 UCUB. • Consequently, RC should be given equal consideration in patients with pT3 and pT4a UCUB.
KW - Bladder cancer
KW - Prognosis
KW - Survival
KW - Urothelial carcinoma
KW - pT4
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U2 - 10.1111/j.1464-410X.2010.09590.x
DO - 10.1111/j.1464-410X.2010.09590.x
M3 - Article
C2 - 20860649
AN - SCOPUS:79952611931
SN - 1464-4096
VL - 107
SP - 905
EP - 911
JO - BJU International
JF - BJU International
IS - 6
ER -
