Short-term mortality risks among patients with non-metastatic bladder cancer

Abstract

Background Population-based analysis for the short-term non-bladder cancer related mortality among patients with non-metastatic bladder cancer is currently lacking. The objective of the current study was to assess and quantify cause of death after bladder cancer diagnosis. Methods The custom Surveillance, Epidemiology, and End Results (SEER) dataset for standardized mortality ratios (SMRs) was utilized to identify 24,074 patients who were diagnosed with nonmetastatic (M0) bladder cancer from 2014 to 2015. SMRs for causes of death were calculated. Risk factors for bladder cancer-specific mortality, competing mortality, second-cancer mortality, and noncancer mortality were determined using either multivariable Cox or competing risk regression models. Results Among all the 4179 (17.4%) deaths occurred during the follow-up period, almost half of them (44.2%) were attributed to non-bladder cancer cause, including second non-bladder cancer (10%) and other non-cancer causes (34.2%). The most common noncancer causes of death were heart diseases followed by chronic obstructive pulmonary disease. Patients had a higher risk of death from second malignancies (SMR, 1.59; 95% CI, 1.47–1.74) compared with death from first malignancies in the US general population, and also had higher risks of death from heart diseases (SMR, 1.29; 95% CI, 1.18–1.40) and chronic obstructive pulmonary disease (SMR, 1.52; 95% CI, 1.29–1.79) compared with the US general population. Additionally, some risk factors for competing second malignancies or noncancer mortality were determined, such as age, gender, marital status and treatment modalities. Conclusions Death from non-bladder cancer cause contributed to almost half of all deaths in bladder cancer survivors during the short-term follow-up period. These findings can inform medical management and assist clinicians in counseling those survivors regarding their short-term health risks.

Effect of intravesical chemotherapy on the survival of patients with non-muscle-invasive bladder cancer undergoing transurethral resection: a retrospective cohort study among older adults

“…Secondly, overall survival could be influenced by non-cancer related co-morbid conditions. 14 Our study findings on higher mortality among older patients, and those with grade IV and multiple in-situ tumors align with the current evidence. 15,16 Literature shows that older patients are less likely to receive intravesical therapy.…”

Surgical benchmarks, mid-term oncological outcomes, and impact of surgical team composition on simultaneous enbloc robot-assisted radical cystectomy and nephroureterectomy

“…Furthermore, the procedure resulted in a limited postoperative complication rate. The mid-term oncological outcomes were in line with the survival estimates for urothelial bladder cancer [21,22]. As such, these findings support the findings from previous reports [6][7][8][9][10][11] regarding surgical safety while adding information in terms of midterm oncological outcomes.…”

Long-Term Cardiovascular Mortality among 80,042 Older Patients with Bladder Cancer

“…Recent European Association of Urology Guidelines lack recommendations on the risk of CVD-related death in older patients with BC and focus only on cancer-related deaths [ 9 , 10 ]. Although current studies have reported higher proportions of noncancer deaths (including CVD-related deaths) among all BC patients [ 11 , 12 , 13 , 14 , 15 , 16 ] and nonmetastatic BC patients [ 17 ], such studies have not compared the transforming trend of the competing risks of CVD and BC-related death. Furthermore, because these studies lack stratification according to different age subgroups, their results may not be generalizable to older BC patients [ 11 , 12 , 17 ].…”

“…Although current studies have reported higher proportions of noncancer deaths (including CVD-related deaths) among all BC patients [ 11 , 12 , 13 , 14 , 15 , 16 ] and nonmetastatic BC patients [ 17 ], such studies have not compared the transforming trend of the competing risks of CVD and BC-related death. Furthermore, because these studies lack stratification according to different age subgroups, their results may not be generalizable to older BC patients [ 11 , 12 , 17 ]. Most studies have simply delineated the composite CVD death outcome or specific CVD death outcomes, such as fatal heart disease [ 11 , 13 ].…”