Top

World Journal of Urology

Published in:

01-08-2010 | Original Article

Treatment and outcome in muscle invasive bladder cancer: a population-based survey

Authors: Anna M. Leliveld, Benjamin H. J. Doornweerd, Esther Bastiaannet, Michael Schaapveld, Igle J. de Jong

Published in: World Journal of Urology | Issue 4/2010

Abstract

Objective

To assess treatments and survival of patients with muscle invasive bladder cancer (MIBC) in the Comprehensive Cancer Center Northern Netherlands (CCCN) region.

Study design and setting

Retrospective cohort analysis. Data of 548 patients with MIBC diagnosed between 1997 and 2002 were collected from the CCCN cancer registry. All had a follow-up of at least 5 years. Logistic regression analysis on treatments as well as survival analysis was performed.

Results

The treatments were radical cystectomy in 205/548 (37.5%) patients. TUR plus radiotherapy in 246 (44.9%) and palliation in 97 (17.7%). Multivariate analysis identified TNM stage (P < 0.0001) and age (P < 0.0001) as independent variables for cystectomy. Hospital type and year of diagnosis were not significant different between patients treated by cystectomy versus other type of treatment. TNM stage (P < 0.0001), age (P = 0.0043), and comorbidity (P = 0.0028) were independent variables for disease-specific survival (DSS) after cystectomy.

Conclusion

In the CCCN region, only 1/3 of patients with MIBC were treated with radical cystectomy. TNM stage and age were identified as main variables for the choice for cystectomy. TNM stage, age, and comorbidity were independent variables for disease-specific survival after cystectomy.

Cancer Registry IKC. 7-4-2009. Ref Type: Generic

Kirkali Z, Chan T, Manoharan M, Algaba F, Busch C, Cheng L et al (2005) Bladder cancer: epidemiology, staging and grading, and diagnosis. Urology 66(6 Suppl 1):4–34CrossRefPubMed

Stenzl A, Cowan NC, De Santis M, Jakse G, Kuczyk MA, Merseburger AS et al (2009) The updated EAU guidelines on muscle-invasive and metastatic bladder cancer. Eur Urol 55(4):815–825CrossRefPubMed

Babjuk M, Oosterlinck W, Sylvester R, Kaasinen E, Bohle A, Palou-Redorta J (2008) EAU guidelines on non-muscle-carcinoma of the bladder. Eur Urol 54(2):303–314CrossRefPubMed

Prout GR Jr, Wesley MN, Yancik R, Ries LA, Havlik RJ, Edwards BK (2005) Age and comorbidity impact surgical therapy in older bladder carcinoma patients: a population-based study. Cancer 104(8):1638–1647CrossRefPubMed

van Rhijn BW, Burger M, Lotan Y, Solsona E, Stief CG, Sylvester RJ et al (2009) Recurrence and progression of disease in non-muscle-invasive bladder cancer: from epidemiology to treatment strategy. Eur Urol 56(3):430–442CrossRefPubMed

Sternberg CN, Vogelzang NJ (2003) Gemcitabine, paclitaxel, pemetrexed and other newer agents in urothelial and kidney cancers. Crit Rev Oncol Hematol 46(Suppl):S105–S115CrossRefPubMed

Sobin LH, Fleming ID (1997) TNM classification of malignant tumors, fifth edition. Union Internationale Contre le Cancer and the American Joint Committee on Cancer. Cancer 80(9):1803–1804CrossRefPubMed

Snyder C, Harlan L, Knopf K, Potosky A, Kaplan R (2003) Patterns of care for the treatment of bladder cancer. J Urol 169(5):1697–1701CrossRefPubMed

10.

Visser O, Nieuwenhuijzen JA, Horenblas S (2005) Local recurrence after cystectomy and survival of patients with bladder cancer: a population based study in greater Amsterdam. J Urol 174(1):97–102CrossRefPubMed

11.

Figueroa AJ, Stein JP, Dickinson M, Skinner EC, Thangathurai D, Mikhail MS et al (1998) Radical cystectomy for elderly patients with bladder carcinoma: an updated experience with 404 patients. Cancer 83(1):141–147CrossRefPubMed

12.

Clark PE, Stein JP, Groshen SG, Cai J, Miranda G, Lieskovsky G et al (2005) Radical cystectomy in the elderly: comparison of clinical outcomes between younger and older patients. Cancer 104(1):36–43CrossRefPubMed

13.

Stroumbakis N, Herr HW, Cookson MS, Fair WR (1997) Radical cystectomy in the octogenarian. J Urol 158(6):2113–2117CrossRefPubMed

14.

Charlson ME, Pompei P, Ales KL, MacKenzie CR (1987) A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. J Chronic Dis 40(5):373–383CrossRefPubMed

15.

Stenzl A, Cowan NC, De Santis M, Jakse G, Kuczyk M, Merseburger AS et al (2009) Guidelines on bladder cancer, muscle invasive and metastatic. European Association of Urology Guidelines

16.

Nieuwenhuijzen JA, Pos F, Moonen LM, Hart AA, Horenblas S (2005) Survival after bladder-preservation with brachytherapy versus radical cystectomy; a single institution experience. Eur Urol 48(2):239–245CrossRefPubMed

17.

Steen-Banasik E, Ploeg M, Witjes JA, van Rey FS, Idema JG, Heijbroek RP et al (2009) Brachytherapy versus cystectomy in solitary bladder cancer: a case control, multicentre, East-Netherlands study. Radiother Oncol 93(2):352–357CrossRefPubMed

18.

Hamel MB, Henderson WG, Khuri SF, Daley J (2005) Surgical outcomes for patients aged 80 and older: morbidity and mortality from major noncardiac surgery. J Am Geriatr Soc 53(3):424–429CrossRefPubMed

19.

Ghoneim MA, Abol-Enein H (2004) Lymphadenectomy with cystectomy: is it necessary and what is its extent? Eur Urol 46(4):457–461PubMed

20.

Mills RD, Turner WH, Fleischmann A, Markwalder R, Thalmann GN, Studer UE (2001) Pelvic lymph node metastases from bladder cancer: outcome in 83 patients after radical cystectomy and pelvic lymphadenectomy. J Urol 166(1):19–23CrossRefPubMed

21.

Stein JP, Lieskovsky G, Cote R, Groshen S, Feng AC, Boyd S et al (2001) Radical cystectomy in the treatment of invasive bladder cancer: long-term results in 1,054 patients. J Clin Oncol 19(3):666–675PubMed

22.

Mungan NA, Aben KK, Schoenberg MP, Visser O, Coebergh JW, Witjes JA et al (2000) Gender differences in stage-adjusted bladder cancer survival. Urology 55(6):876–880CrossRefPubMed

23.

Lodde M, Palermo S, Comploj E, Signorello D, Mian C, Lusuardi L et al (2005) Four years experience in bladder preserving management for muscle invasive bladder cancer. Eur Urol 47(6):773–778CrossRefPubMed

24.

Bochner BH, Kattan MW, Vora KC (2006) Postoperative nomogram predicting risk of recurrence after radical cystectomy for bladder cancer. J Clin Oncol 24(24):3967–3972CrossRefPubMed

25.

Karakiewicz PI, Shariat SF, Palapattu GS, Gilad AE, Lotan Y, Rogers CG et al (2006) Nomogram for predicting disease recurrence after radical cystectomy for transitional cell carcinoma of the bladder. J Urol 176(4 Pt 1):1354–1361CrossRefPubMed

26.

Dalbagni G, Genega E, Hashibe M, Zhang ZF, Russo P, Herr H et al (2001) Cystectomy for bladder cancer: a contemporary series. J Urol 165(4):1111–1116CrossRefPubMed

27.

Zaak D, Burger M, Otto W, Bastian PJ, Denzinger S, Stief CG, et al. (2009) Predicting individual outcomes after radical cystectomy: an external validation of current nomograms. BJU Int [Epub ahead of print]

Title: Treatment and outcome in muscle invasive bladder cancer: a population-based survey
Authors: Anna M. Leliveld
Benjamin H. J. Doornweerd
Esther Bastiaannet
Michael Schaapveld
Igle J. de Jong
Publication date: 01-08-2010
Publisher: Springer-Verlag
Published in: World Journal of Urology / Issue 4/2010
Print ISSN: 0724-4983
Electronic ISSN: 1433-8726
DOI: https://doi.org/10.1007/s00345-010-0546-2

At a glance: The STEP trials

Springer Medicine

Treatment and outcome in muscle invasive bladder cancer: a population-based survey

Abstract

Objective

Study design and setting

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Objective

Study design and setting

Results

Conclusion

Please log in to get access to this content

Other articles of this Issue 4/2010

Evolution on experimental animal model for upper urothelium carcinogenesis

Bladder reconstruction with adipose-derived stem cell-seeded bladder acellular matrix grafts improve morphology composition

Viral macrophage inflammatory protein-II improves acute rejection in allogeneic rat kidney transplants

Contemporary open partial nephrectomy is associated with diminished procedure-specific morbidity despite increasing technical challenges: a single institutional experience

Expression and clinical significance of hepaCAM and VEGF in urothelial carcinoma

External validation of the preoperative anatomical classification for prediction of complications related to nephron-sparing surgery