Comparative Outcomes of Primary Versus Recurrent High-risk Non–muscle-invasive and Primary Versus Secondary Muscle-invasive Bladder Cancer After Radical Cystectomy: Results from a Retrospective Multicenter Study

Grossmann, Nico C.; Rajwa, Paweł; Quhal, Fahad; König, Frederik; Mostafaei, Hadi; Laukhtina, Ekaterina; Mori, Keiichiro; Katayama, Satoshi; Motlagh, Reza Sari; Fankhauser, Christian Daniel; Mattei, Agostino; Moschini, Marco; Chłosta, Piotr; Teoh, Jeremy Yuen‐Chun; Compérat, Éva; Babjuk, Marek; Abufaraj, Mohammad; Karakiewicz, Pierre I.; Shariat, Shahrokh F.; Pradère, Benjamin

doi:10.1016/j.euros.2022.02.011

Cited by 10 publications

(8 citation statements)

References 30 publications

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“…Available data comparing prognosis of patients with primMI vs. secMI following RC was concisely discussed by Møller et al and is summarized here again (Table 1) [2][3][4][5][6][7][8][9][10][11][12][13]. The majority of these studies confirm these findings from Norway showing no differences in survival rates.…”

supporting

confidence: 57%

“…This relatively high percentage (compared to international literature) was partly explained by the assignment of patients primarily diagnosed with non-muscle-invasive UCB to the primMI group if they progressed to muscle-invasive stage within 4 months after initial diagnosis. Within the RC group, cancer-specific mortality (CSM) at 5 years was 42% and 41% for patients with primMI and secMI, respectively, with no significant difference (HR: 0.93, p ¼ .78).Available data comparing prognosis of patients with primMI vs. secMI following RC was concisely discussed by Møller et al and is summarized here again (Table 1) [2][3][4][5][6][7][8][9][10][11][12][13]. The majority of these studies confirm these findings from Norway showing no differences in survival rates.…”

mentioning

confidence: 89%

“…The majority of these studies confirm these findings from Norway showing no differences in survival rates. However, a recent multicentre study of 572 patients undergoing RC without neoadjuvant chemotherapy demonstrated higher 5year-CSM rates for secMI compared to primMI (53.5 vs. 35.5%, p < .001) [12]. In a paper published more than 10 years ago in the Scandinavian Journal of Urology including 607 patients treated with RC for cT1 UCB, we demonstrated a 5-year-CSM of 24% for this group, although slightly more than one third of these patients showed an upstaging in the RC specimen (!pT2,pN0 or pTany,pNþ) [14].…”

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confidence: 93%

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Bladder cancer with secondary muscle invasion – a prognostic dilemma

May

Wolff

Brookman‐May

et al. 2022

Scandinavian Journal of Urology

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With great interest we have read the excellent manuscript by Møller et al. in which survival rates of patients with bladder cancer (UCB) and primary muscle invasion (primMI) were compared to those of patients with secondary muscle invasion (secMI) [1]. For this purpose, the authors analyzed 650 patients within the Cancer Registry of Norway treated with curative intent from 2008 to 2012. The vast majority underwent radical cystectomy (RC; n ¼ 556, 86%). In the RC group, 506 patients (91%) had primMI. This relatively high percentage (compared to international literature) was partly explained by the assignment of patients primarily diagnosed with non-muscle-invasive UCB to the primMI group if they progressed to muscle-invasive stage within 4 months after initial diagnosis. Within the RC group, cancer-specific mortality (CSM) at 5 years was 42% and 41% for patients with primMI and secMI, respectively, with no significant difference (HR: 0.93, p ¼ .78).Available data comparing prognosis of patients with primMI vs. secMI following RC was concisely discussed by Møller et al. and is summarized here again (Table 1) [2][3][4][5][6][7][8][9][10][11][12][13]. The majority of these studies confirm these findings from Norway showing no differences in survival rates. However, a recent multicentre study of 572 patients undergoing RC without neoadjuvant chemotherapy demonstrated higher 5year-CSM rates for secMI compared to primMI (53.5 vs. 35.5%, p < .001) [12]. In a paper published more than 10 years ago in the Scandinavian Journal of Urology including 607 patients treated with RC for cT1 UCB, we demonstrated a 5-year-CSM of 24% for this group, although slightly more than one third of these patients showed an upstaging in the RC specimen (!pT2,pN0 or pTany,pNþ) [14]. However, it is also undoubted that a general indication for early RC in all

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confidence: 57%

mentioning

confidence: 89%

mentioning

confidence: 93%

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Bladder cancer with secondary muscle invasion – a prognostic dilemma

May

Wolff

Brookman‐May

et al. 2022

Scandinavian Journal of Urology

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“…Much research has arisen on blood-based biomarkers to help guide clinical decision making in muscle-invasive BCa [ 12 , 13 , 14 ]. Despite substantial efforts, no biomarker is standard in the clinical setting so far, as the majority of studies suffer from inadequate study designs, analysis and reporting [ 15 ].…”

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confidence: 99%

Blood-Based Biomarkers as Prognostic Factors of Recurrent Disease after Radical Cystectomy: A Systematic Review and Meta-Analysis

Ofner

Laukhtina

Hassler

et al. 2023

IJMS

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Survival outcomes after radical cystectomy (RC) for bladder cancer (BCa) have not improved in recent decades; nevertheless, RC remains the standard treatment for patients with localized muscle-invasive BCa. Identification of the patients most likely to benefit from RC only versus a combination with systemic therapy versus systemic therapy first/only and bladder-sparing is needed. This systematic review and meta-analysis pools the data from published studies on blood-based biomarkers to help prognosticate disease recurrence after RC. A literature search on PubMed and Scopus was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) statement. Articles published before November 2022 were screened for eligibility. A meta-analysis was performed on studies investigating the association of the neutrophil-to-lymphocyte ratio (NLR), the only biomarker with sufficient data, with recurrence-free survival. The systematic review identified 33 studies, and 7 articles were included in the meta-analysis. Our results demonstrated a statistically significant correlation between elevated NLR and an increased risk of disease recurrence (HR 1.26; 95% CI 1.09, 1.45; p = 0.002) after RC. The systematic review identified various other inflammatory biomarkers, such as interleukin-6 or the albumin-to-globulin ratio, which have been reported to have a prognostic impact on recurrence after RC. Besides that, the nutritional status, factors of angiogenesis and circulating tumor cells, and DNA seem to be promising tools for the prognostication of recurrence after RC. Due to the high heterogeneity between the studies and the different cut-off values of biomarkers, prospective and validation trials with larger sample sizes and standardized cut-off values should be conducted to strengthen the approach in using biomarkers as a tool for risk stratification in clinical decision-making for patients with localized muscle-invasive BCa.

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“…In a recent issue of European Urology Open Science , Grossmann et al [1] report on their comparison of oncological outcomes between early and deferred radical cystectomy (RC) in patients with non–muscle-invasive bladder cancer (NMIBC). Although their study is retrospective, it has the merit of reflecting daily clinical practice and evaluating a highly heterogeneous disease.…”

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confidence: 99%