MP64-17 LACK OF IMPROVEMENT IN RADICAL CYSTECTOMY OUTCOMES OVER 20 YEARS?

Abstract

You have accessJournal of UrologyBladder Cancer: Natural History and Pathophysiology1 Apr 2015MP64-17 LACK OF IMPROVEMENT IN RADICAL CYSTECTOMY OUTCOMES OVER 20 YEARS? Hristos Kaimakliotis, Jane S. Cho, M. Francesca Monn, Jose A. Pedrosa, Paul Gellhaus, K. Clint Cary, Liang Cheng, Richard Bihrle, and Michael O. Koch Hristos KaimakliotisHristos Kaimakliotis More articles by this author , Jane S. ChoJane S. Cho More articles by this author , M. Francesca MonnM. Francesca Monn More articles by this author , Jose A. PedrosaJose A. Pedrosa More articles by this author , Paul GellhausPaul Gellhaus More articles by this author , K. Clint CaryK. Clint Cary More articles by this author , Liang ChengLiang Cheng More articles by this author , Richard BihrleRichard Bihrle More articles by this author , and Michael O. KochMichael O. Koch More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2015.02.2328AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES With randomized trial data indicating the benefit of neoadjuvant chemotherapy for muscle invasive bladder cancer and assumed improvements in surgical technique and perioperative supportive care over the last two decades, we hypothesized that survival for patients undergoing radical cystectomy for bladder cancer would be better in the last decade compared to patients from the decade prior. METHODS Our institutional bladder cancer database was queried for all patients with urothelial bladder cancer who underwent radical cystectomy for curative intent before and after 2003. Survival outcomes were analyzed using Kaplan Meier methodology and log rank test. RESULTS 1443 patients were identified, 446 prior to 2003 and 997 after 2003. The proportion of patients undergoing neoadjuvant chemotherapy was significantly different between the two groups (p=0.003). However, there was no overall survival difference between groups (p=0.985). Patients undergoing radical cystectomy after 2003 were older (p=0.037) with a higher proportion of octogenarians (p=0.009). Furthermore, they had more advanced disease at TURBT and cystectomy (p=0.049 and p<0.001, respectively), and a higher proportion of females (p=0.001). Lymph node involvement and presence of variant histology were also higher among the post 2003 patients (p<0.001). CONCLUSIONS Despite advances in our understanding and management of urothelial bladder cancer, survival at a large single institutional cohort has remained largely unchanged over a twenty year period. There were significant differences in clinicopathological characteristics between patients undergoing radical cystectomy at our institution before and after 2003, which may account for the lack of change in survival. © 2015 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 193Issue 4SApril 2015Page: e804-e805 Advertisement Copyright & Permissions© 2015 by American Urological Association Education and Research, Inc.MetricsAuthor Information Hristos Kaimakliotis More articles by this author Jane S. Cho More articles by this author M. Francesca Monn More articles by this author Jose A. Pedrosa More articles by this author Paul Gellhaus More articles by this author K. Clint Cary More articles by this author Liang Cheng More articles by this author Richard Bihrle More articles by this author Michael O. Koch More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...