MP58-13 OUTCOME REPORTING AFTER RADICAL CYSTECTOMY FOR UROTHELIAL CARCINOMA OF THE BLADDER USING ONCOLOGICAL TRIFECTA AND PENTAFECTA

Abstract

treatment delay. At time of RC, high risk patients more often had occult lymph node metastasis (39% v. 26.7% p1⁄40.04) and tumor upstaging to pT3/4 disease (54% v. 40% p<0.001), with significantly fewer patients achieving pT0 status (2.5% v. 12.1% p1⁄40.004). There was no difference in adjuvant chemotherapy rates (26% v. 25% p1⁄40.8). Two and five year cancer specific survival (CSS) was 85% and 62.3% for low risk patients, but only 59.5% and 42% for high risk patients (log rank1⁄40.006, Fine-Gray competing risk analysis sub-HR1⁄4 2.1 [95% CI1⁄41.4 3.2]). Compared to those without risk factors, the odds ratio for bladder cancer specific mortality (BCSM) was 1.3 (95%CI1⁄40.7-2.5) for one risk factor and 3.2 (95%CI1⁄41.7-5.8) for 2 risk factors. On multivariable analysis, only hydronephrosis (2.2 [95%CI1⁄41.2-4.2]) and mixed histology (2.4 [95%CI1⁄41.2-4.8]) were independently associated with BCSM. CONCLUSIONS: RC alone provides good oncologic outcomes to many cT2 MIBC patients without preoperative adverse risk factors, particularly if hydronephosis & mixed variant histology are absent. However, even in “low risk” patients, tumor upstaging & lymph node involvement is not trivial, which must be included in informed decision making.