PD29-09 COMPARISON OF SURVIVAL OUTCOMES AMONG PATIENTS WITH POSITIVE SOFT TISSUE MARGINS VERSUS POSITIVE NON-SOFT TISSUE MARGINS ALONE FOLLOWING RADICAL CYSTECTOMY FOR MUSCLE INVASIVE BLADDER CANCER

Abstract

You have accessJournal of UrologyCME1 Apr 2023PD29-09 COMPARISON OF SURVIVAL OUTCOMES AMONG PATIENTS WITH POSITIVE SOFT TISSUE MARGINS VERSUS POSITIVE NON-SOFT TISSUE MARGINS ALONE FOLLOWING RADICAL CYSTECTOMY FOR MUSCLE INVASIVE BLADDER CANCER Julian Rowe, Andrew Gabrielson, Una Choi, Sunil Patel, Trinity Bivalacqua, Max Kates, and Noah Hahn Julian RoweJulian Rowe More articles by this author , Andrew GabrielsonAndrew Gabrielson More articles by this author , Una ChoiUna Choi More articles by this author , Sunil PatelSunil Patel More articles by this author , Trinity BivalacquaTrinity Bivalacqua More articles by this author , Max KatesMax Kates More articles by this author , and Noah HahnNoah Hahn More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003315.09AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Radical cystectomy (RC) is a mainstay treatment for patients with muscle-invasive bladder cancer. While positive soft tissue surgical margins (STSM) portend worse outcomes compared to negative margins, outcomes from positive STSM vs positive non-STSM alone remain understudied. We compare outcomes among patients with positive STSM, positive non-STSM alone, and negative margins following RC. METHODS: A retrospective cohort study was conducted using a single-institution RC registry from 2000-2018. Inclusion criteria included age>18, histologically confirmed urothelial carcinoma, RC with curative intent, and available pathology report. We defined 3 patient groups: 1) positive STSM (adjacent muscle or pelvic organs) ±positive non-STSM, 2) positive non-STSM (urethra or ureter) alone, 3) negative margins. Kaplan-Meier (KM) analysis with log-rank test was used to compare recurrence-free survival (RFS) and overall survival (OS). RESULTS: A total of 236 patients with positive margins and 1,138 patients with negative margins after RC were included. Of those with positive margins, 83 (35.2%) had positive STSM and 153 (64.9%) had positive non-STSM alone. There was no difference in age, adjuvant chemotherapy use, pN+rate between those with positive STSM compared to non-STSM. There was significantly higher variant histology (25.9% vs 8.4%, p<0.001) as well as NAC utilization (43.2% vs 25.2%, p=0.009) in positive STSM compared to non-STSM. Patients with positive STSMs demonstrated significantly worse median RFS (10.5 months vs 35.1 months, p=0.009) and OS (13.7 vs 27.8 months, p=0.013) compared to those with positive non-STSMs alone. Patients with positive non-STSM alone had significantly worse median RFS (35.1 vs 150.8 months, p<0.001) and OS (27.8 vs 87.7 months, p<0.001) compared to those with negative margins. KM analysis demonstrated distinct RFS and OS outcomes between the 3 groups (Figure 1). CONCLUSIONS: Positive STSM were associated with worse RFS and OS compared to positive non-STSM however positive non-STSM alone represents a distinct clinical entity from those with negative margins, and these data can inform patient counseling. This study was limited by differential rates of variant histology and NAC use. Source of Funding: NA © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e827 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Julian Rowe More articles by this author Andrew Gabrielson More articles by this author Una Choi More articles by this author Sunil Patel More articles by this author Trinity Bivalacqua More articles by this author Max Kates More articles by this author Noah Hahn More articles by this author Expand All Advertisement PDF downloadLoading ...