PD36-10 SURVIVAL DIFFERENCES BETWEEN PRIMARY VERSUS SECONDARY MUSCLE-INVASIVE BLADDER CANCER PATIENTS TREATED WITH RADICAL CYSTECTOMY

Abstract

You have accessJournal of UrologyCME1 Apr 2023PD36-10 SURVIVAL DIFFERENCES BETWEEN PRIMARY VERSUS SECONDARY MUSCLE-INVASIVE BLADDER CANCER PATIENTS TREATED WITH RADICAL CYSTECTOMY Cristina Cano Garcia, Severine Banek, Mike Wenzel, Benedikt Hoeh, Clara Humke, Clarissa Wittler, Jens Köllermann, Pierre I. Karakiewicz, Philipp Mandel, Felix K.H. Chun, and Luis A. Kluth Cristina Cano GarciaCristina Cano Garcia More articles by this author , Severine BanekSeverine Banek More articles by this author , Mike WenzelMike Wenzel More articles by this author , Benedikt HoehBenedikt Hoeh More articles by this author , Clara HumkeClara Humke More articles by this author , Clarissa WittlerClarissa Wittler More articles by this author , Jens KöllermannJens Köllermann More articles by this author , Pierre I. KarakiewiczPierre I. Karakiewicz More articles by this author , Philipp MandelPhilipp Mandel More articles by this author , Felix K.H. ChunFelix K.H. Chun More articles by this author , and Luis A. KluthLuis A. Kluth More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003334.10AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Differentiation exists between primary muscle-invasive bladder cancer (MIBC) patients and prior history of non-muscle invasive bladder cancer (NMIBC) with progression to secondary MIBC. However, data comparing survival of primary vs. secondary MIBC treated with radical cystectomy (RC) are reporting conflicting results. Therefore, we aim to test the survival difference between primary vs. secondary MIBC treated with RC within our tertiary-case database. METHODS: We relied on an institutional tertiary-care database to identify non-metastatic primary and secondary MIBC patients who underwent RC between 2010 and 2021. Specifically, the definition of MIBC consisted of muscle invasion presented in the histological specimen from transurethral resection of the bladder. Kaplan Meier curves depicted two-year overall survival (OS) and recurrence-free survival (RFS). Multivariable cox regression models tested independent predictor status of primary vs. secondary MIBC in analyses addressing OS and RFS. Co-variables consisted of age, sex, pT stage, pN stage, R status, and histology (pure urothelial vs. mixed), as well as intravesical therapy, neoadjuvant chemotherapy and adjuvant chemotherapy. RESULTS: Of 107 MIBC patients treated with RC, 82 (77%) exhibited primary and 25 (23%) secondary MIBC. Median follow-up was 12.8 months. Higher rates of pN0 (60 vs. 40%, p=0.01) were recorded in primary compared to secondary MIBC patients. At two-year follow-up, no statistically significant OS difference was observed between primary vs. secondary MIBC patients (55.3 vs. 46.0%, p=0.45). Similarly, in multivariable cox regression models, secondary MIBC did not predict lower OS compared to primary MIBC (Hazard Ratio (HR): 1.30, 95% confidence interval (CI): 0.59-2.88, p=0.51). At two-year follow-up, no PFS difference was observed between primary vs. secondary MIBC patients (43.2 vs. 41.2%, p=0.81). Similarly, in multivariable cox regression model, secondary MIBC did not predict lower RFS compared to primary MIBC (HR: 1.16, 95% CI: 0.52-2.60, p=0.72). CONCLUSIONS: In this tertiary-based institution study comparing, secondary MIBS patients exhibited lower OS than their primary MIBC counterparts. However, no statistically significant OS were observed between these two examined groups. Moreover, no RFS differences were observed between primary vs. secondary MIBC patients. Nonetheless, ongoing patient surveillance is required to identify early MIBC progression in patients with NMIBC. Source of Funding: None © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e984 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Cristina Cano Garcia More articles by this author Severine Banek More articles by this author Mike Wenzel More articles by this author Benedikt Hoeh More articles by this author Clara Humke More articles by this author Clarissa Wittler More articles by this author Jens Köllermann More articles by this author Pierre I. Karakiewicz More articles by this author Philipp Mandel More articles by this author Felix K.H. Chun More articles by this author Luis A. Kluth More articles by this author Expand All Advertisement PDF downloadLoading ...