PD41-11 EVALUATION OF A BREAST CANCER SPECIFIC CIRCULATING TUMOR CELL (CTC) PLATFORM IN DIFFERENT STAGES OF BLADDER CANCER REFLECTS A COMMON MOLECULAR BACKGROUND

Abstract

End Result (SEER) national cancer registry treated with cystectomy and lymph node dissection between the years of 1988 and 2011. Cases were grouped by tumor stage (T stage) and LN status. A total of 18 LNs removed was used as a threshold for thorough LN dissection. Survival was compared using stratified Kaplan-Meier and multivariate Cox-proportional hazard models. Multivariate analyses controlled for age, race, gender, and tumor grade. RESULTS: A total of 14,828 patients were identified for analysis, 3,649 (25%) of who were node positive (Nþ). A median of 10 LNs (interquartile range (IQR) 5-18) were removed per patient, which did not differ meaningfully between Nþ and Npatients. Within each respective T stage, Nþ patients had worse CSS than Npatients (fig 1). However, 5-year CSS of low T stage, Nþ patients was similar to that of high T stage, Npatients (5-year CSS T2Nþ 1⁄4 49%, T3N-1⁄4 56%). Among those with >18 LN dissected, those with locally confined ( T2) Nþ disease and those with locally extensive (T3/T4) Ndisease had a similar risk of death compared to those with T2N(HR 3.91, 95% CI 3.04-5.02 and HR 3.68, 95% CI 3.08-4.41, respectively.) CONCLUSIONS: While the current AJCC staging system classifies all lymph node positive bladder cancer patients as Stage IV, CSS among node positive patients is heavily influenced by the primary tumor stage. In this cohort, those with low stage, Nþ disease had a similar 5-year survival to those with high stage, Ndisease. This information could be used to provide better prognostic information and improve stratification for clinical trials in advanced bladder cancer.