The Relationship of Local Control to Distant Metastasis in Muscle Invasive Bladder Cancer

Pollack, Alan; Zagars, Gunar K.; Cole, Christopher J.; Dinney, Colin P.N.; Swanson, David A.; Grossman, H. Barton

doi:10.1097/00005392-199512000-00026

Cited by 14 publications

(16 citation statements)

References 15 publications

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“…40 Recent reports did not find the prognostic significance of vascular invasion in patients treated by radical cystectomy. 16,25 Vascular invasion did not appear to influence patient outcome significantly in our investigation, although patients with vascular invasion did have an increased risk of lymph node metastasis (25% vs. 13%).…”

Section: Discussioncontrasting

confidence: 46%

See 1 more Smart Citation

Tumor size predicts the survival of patients with pathologic stage t2 bladder carcinoma

Liu

Neumann

Scherer

et al. 1999

Cancer

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Section: Discussioncontrasting

confidence: 46%

“…11,16,25,[35][36][37][38][39][40][41][42] Fossa et al found that vascular in- 36 Other studies have refuted the importance of vascular invasion. 16,25,40 -42 Larsen et al found that patients with vascular invasion did not necessarily have a worse prognosis.…”

Section: Discussionmentioning

confidence: 99%

Tumor size predicts the survival of patients with pathologic stage t2 bladder carcinoma

Liu

Neumann

Scherer

et al. 1999

Cancer

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“…After this study, several studies were conducted to compare clinical outcomes in terms of overall and recurrence-free survival rates (4)(5)(6)(7)(8)(9). In contrast with the findings of Jewett in 1952, most of these studies were unable to find a prognostic difference between these subgroups.…”

Section: Introductionmentioning

confidence: 99%

Pathological staging of muscle invasive bladder cancer: is substaging of pT2 tumors really necessary?

Tokgöz¹,

Türkölmez²,

Reşorlu³

et al. 2007

Int. braz j urol.

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Objective: Compare clinical outcomes in patients having urothelial tumors invading less than one half of the depth of bladder muscle and greater than one half of bladder muscle and, to determine various clinical variables as predictive factors for survival. Materials and Methods: According to our inclusion criteria, 57 patients among cases with T2 bladder tumor were selected. Thirty-five patients (61.4 %) had pT2a (Group-1) and 22 patients (38.6%) had pT2b (Group-2) muscle invasive tumors. Mean follow up time was 7.3 years for Group-1, and 6.1 years for Group-2. Multivariate analysis was performed in order to identify possible correlation of clinical variables like age, gender, grade of primary tumor, appearance of local and/ or distant metastasis with patient outcome. Results: Five year recurrence-free and overall survival rates were 69.1% and 44.3% for patients with pT2a tumor, whereas these ratios were 66.1% and 43%, respectively for patients with pT2b tumor (p = 0.896; p = 0.975). Mean overall and progression-free survival times were 87.7 ± 13.8 and 116 ± 13.12 months for Group-1, while they were 73.8 ± 13.7 and 88.85 ± 12.55 months for Group-2, respectively. On both univariate and multivariate analysis, age was noticed as an independent predictive factor for survival. Conclusions: The depth of muscle invasion in bladder tumors has no prognostic significance. Recurrence of the disease either locally or at distant sites dramatically shortens patients' life. Being older than 60 years old during the time of radical surgery, is also a bad prognostic factor for overall and progression-free survival.

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“…19 Additionally, there is an evidence that local failure often precedes but uncommonly follows the development of distant metastasis, suggesting that local failure may seed distant disease. 20 Even if LF did not reduce the risk of DM or affect survival, there is often considerable morbidity associated with LF and efforts to reduce LF may improve patient quality-of-life. 2 Given the association between LF and development of distant disease, methods to improve local control may be warranted and may improve survival.…”

Section: Discussionmentioning

confidence: 99%

Effectiveness of postoperative radiotherapy after radical cystectomy for locally advanced bladder cancer

et al. 2019

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Background Local‐regional failure (LF) for locally advanced bladder cancer (LABC) after radical cystectomy (RC) is common even with chemotherapy and is associated with high morbidity/mortality. Postoperative radiotherapy (PORT) can reduce LF and may enhance overall survival (OS) but has no defined role. We hypothesized that the addition of PORT would improve OS in LABC in a large nationwide oncology database. Methods We identified ≥ pT3pN0‐3M0 LABC patients in the National Cancer Database diagnosed 2004‐2014 who underwent RC ± PORT. OS was calculated using Kaplan‐Meier and Cox proportional hazards regression modeling was used to identify predictors of OS. Propensity matching was performed to match RC patients who received PORT vs those who did not. Results 15,124 RC patients were identified with 512 (3.3%) receiving PORT. Median OS was 20.0 months (95% CI, 18.2‐21.8) for PORT vs 20.8 months (95% CI, 20.3‐21.3) for no PORT ( P = 0.178). In multivariable analysis, PORT was independently associated with improved OS: hazard ratio 0.87 (95% CI, 0.78‐0.97); P = 0.008. A one‐to‐three propensity match yielded 1,858 patients (24.9% receiving PORT and 75.1% without). In the propensity‐matched cohort, median OS was 19.8 months (95% CI, 18.0‐21.6) for PORT vs 16.9 months (95% CI, 15.6‐18.1) for no PORT ( P = 0.030). In the propensity‐matched cohort of urothelial carcinoma patients (N = 1,460), PORT was associated with improved OS for pT4, pN+, and positive margins ( P < 0.01 all). Conclusion In this observational cohort, PORT was associated with improved OS in LABC. While the data should be interpreted cautiously, these results lend support to the use of PORT in selected patients with LABC, regardless of histology. Prospective trials of PORT are warranted.

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The Relationship of Local Control to Distant Metastasis in Muscle Invasive Bladder Cancer

Cited by 14 publications

References 15 publications

Tumor size predicts the survival of patients with pathologic stage t2 bladder carcinoma

Tumor size predicts the survival of patients with pathologic stage t2 bladder carcinoma

Pathological staging of muscle invasive bladder cancer: is substaging of pT2 tumors really necessary?

Effectiveness of postoperative radiotherapy after radical cystectomy for locally advanced bladder cancer

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