Perioperative chemotherapy treatment patterns in stage III transitional cell carcinoma (TCC) (1998–2003): A report from the National Cancer Data Base (NCDB)

Abstract

4540 Background: Studies have demonstrated benefits of perioperative chemotherapy in locally advanced TCC. We reviewed chemotherapy treatment patterns in patients with stage III TCC of the bladder and upper urinary tract (UUT) between 1998–2003 to investigate the use of perioperative chemotherapy. Methods: The NCDB collects data on approximately 75% of all newly diagnosed cancer cases annually in the U.S. We queried for all treatments in male and female (≥18 years old) TCC cases diagnosed between 1998 and 2003. Cancer stage (1998–2002) was forward converted to AJCC 6th edition. A total of 223,050 bladder and 11,625 UUT TCC cases were found. Results: Treatment patterns were analyzed in 11,328 patients with stage III bladder TCC and 1,840 patients with stage III UUT TCC, representing 5.0% and 15.8% of all cases, respectively (Table). Satisfactory follow-up was available for approximately 51% of patients. 5.4% (bladder) and 3.5% (UUT) of patients received pre-operative or adjuvant (within 4 mos of surgery) chemotherapy. No significant difference was seen comparing 1998 and 2003 perioperative chemotherapy use for bladder or UUT cancers. Conclusions: No increase in perioperative chemotherapy use occurred over the 5-year period (1998–2003), suggesting chemotherapy is underutilized in the management of surgically resectable stage III TCC of the bladder or UUT. This may reflect a delay in implementing the results of randomized trials recently reported or a low incidence of referral by urologists for perioperative chemotherapy. Further follow-up will determine if this pattern changes over the next 5 years. [Table: see text] No significant financial relationships to disclose.