You have accessJournal of UrologyBladder Cancer: Metastatic Disease1 Apr 20111983 FACTORS INFLUENCING POST-RECURRENCE SURVIVAL IN BLADDER CANCER PATIENTS FOLLOWING RADICAL CYSTECTOMY Anirban Mitra, David Quinn, Tanya Dorff, Eila Skinner, Anne Schuckman, Gus Miranda, Inderbir Gill, and Siamak Daneshmand Anirban MitraAnirban Mitra Los Angeles, CA More articles by this author , David QuinnDavid Quinn Los Angeles, CA More articles by this author , Tanya DorffTanya Dorff Los Angeles, CA More articles by this author , Eila SkinnerEila Skinner Los Angeles, CA More articles by this author , Anne SchuckmanAnne Schuckman Los Angeles, CA More articles by this author , Gus MirandaGus Miranda Los Angeles, CA More articles by this author , Inderbir GillInderbir Gill Los Angeles, CA More articles by this author , and Siamak DaneshmandSiamak Daneshmand Los Angeles, CA More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2011.02.2209AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Disease recurrence following radical cystectomy for bladder cancer is not uncommon and fatal in over 85% of patients. We used a large single-institution cohort to identify clinicopathologic indicators that can potentially predict post-recurrence survival (PRS) in bladder cancer patients following radical cystectomy. METHODS Patients who underwent radical cystectomy for bladder cancer at USC with intent to cure between 1971 and 2005 were retrospectively evaluated. Study inclusion criteria were (a) presence of pathologically documented bladder transitional cell carcinoma on radical cystectomy, and (b) minimum 2-year post-recurrence follow-up if patient was alive. Patients with urethral or upper tract primaries and distant metastasis at time of diagnosis were excluded. Survival data was analyzed using log rank statistics and multivariate models. RESULTS Of the 2,029 patients who met the inclusion criteria, 527 (26%) recurred. Median age was 67 years. Median PRS was 7 months. 487 (92%) patients were dead by the end of the reporting period. 177 (34%), 126 (24%) and 224 (42%) patients had organ-confined, extravesical and node-positive disease, respectively. 80 (15%) patients had upper tract or urethral recurrence, while 70 (13%) had both local and distant recurrence. 231 (44%) patients received post-recurrence chemotherapy. Factors univariately associated with PRS were gender (p=0.024), diversion type (p=0.014), pathologic stage (p<0.001), surgical margin status (p=0.017), lymphovascular invasion (p=0.004), lymph node density (p<0.001), p53 status (p=0.008), time to recurrence (p<0.001), recurrence site (p<0.001), and post-recurrence chemotherapy (p=0.003). Multivariate analysis identified recurrence site and post-recurrence chemotherapy administration as independent predictors of PRS (both, p<0.001). Median PRS with upper tract/urethral recurrence was 49 months, compared to 4–8 months for local and/or distant recurrence. This association was confirmed after stratifying by pathologic stage. Stratification by death within 30 days of recurrence additionally identified lymph node density as an independent predictor of PRS (p=0.025). CONCLUSIONS Bladder cancer recurrence forebodes poor prognosis, with 7 months median survival following recurrence. Upper tract or urethral recurrence has better prognosis than recurrence at other sites. Post-recurrence chemotherapy may improve survival, although prospective trials are needed to confirm this finding. © 2011 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 185Issue 4SApril 2011Page: e793-e794 Advertisement Copyright & Permissions© 2011 by American Urological Association Education and Research, Inc.MetricsAuthor Information Anirban Mitra Los Angeles, CA More articles by this author David Quinn Los Angeles, CA More articles by this author Tanya Dorff Los Angeles, CA More articles by this author Eila Skinner Los Angeles, CA More articles by this author Anne Schuckman Los Angeles, CA More articles by this author Gus Miranda Los Angeles, CA More articles by this author Inderbir Gill Los Angeles, CA More articles by this author Siamak Daneshmand Los Angeles, CA More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...