Radical cystectomy or bladder preservation with radiochemotherapy in elderly patients with muscle-invasive bladder cancer

Retrospective International Study of Cancers of the Urothelial Tract (RISC) Investigators

Jihane Boustani, Aurélie Bertaut, Matthew D. Galsky, Jonathan E. Rosenberg, Joaquim Bellmunt, Thomas Powles, Federica Recine, Lauren C. Harshman, Simon Chowdhury, Guenter Niegisch, Evan Y. Yu, Sumanta K. Pal, Ugo De Giorgi, Simon J. Crabb, Matthieu Caubet, Loïc Balssa, Matthew I. Milowsky, Sylvain Ladoire, Gilles Créhange

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Background: Radical cystectomy (RC) and radiochemotherapy (RCT) are curative options for muscle-invasive bladder cancer (MIBC). Optimal treatment strategy remains unclear in elderly patients. Material and methods: Patients aged 80 years old and above with T2-T4aN0-2M0-Mx MIBC were identified in the Retrospective International Study of Cancers of the Urothelial Tract (RISC) database. Patients treated with RC were compared with those treated with RCT. The impact of surgery on overall survival (OS) was assessed using a Cox proportional hazard model. Progression included locoregional and metastatic relapse and was considered a time-dependent variable. Results: Between 1988 and 2015, 92 patients underwent RC and 72 patients had RCT. Median age was 82.5 years (range 80–100) and median follow-up was 2.90 years (range 0.04–11.10). Median OS was 1.99 years (95%CI 1.17–2.76) after RC and 1.97 years (95%CI 1.35–2.64) after RCT (p = .73). Median progression-free survival (PFS) after RC and RCT were 1.25 years (95%CI 0.80–1.75) and 1.52 years (95%CI 1.01–2.04), respectively (p = .54). In multivariate analyses, only disease progression was significantly associated with worse OS (HR = 10.27 (95%CI 6.63–15.91), p < .0001). Treatment modality was not a prognostic factor. Conclusions: RCT offers survival rates comparable to those observed with RC for patients aged ≥80 years.

Original languageEnglish
Pages (from-to)1-7
Number of pages7
JournalActa Oncologica
DOIs
Publication statusAccepted/In press - Aug 29 2017

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Cystectomy
Chemoradiotherapy
Urinary Bladder Neoplasms
Urinary Bladder
Retrospective Studies
Research Personnel
Muscles
Neoplasms
Survival
Proportional Hazards Models
Disease-Free Survival
Disease Progression
Multivariate Analysis
Survival Rate
Databases
Recurrence
Therapeutics

ASJC Scopus subject areas

  • Hematology
  • Oncology
  • Radiology Nuclear Medicine and imaging

Cite this

Radical cystectomy or bladder preservation with radiochemotherapy in elderly patients with muscle-invasive bladder cancer : Retrospective International Study of Cancers of the Urothelial Tract (RISC) Investigators. / Boustani, Jihane; Bertaut, Aurélie; Galsky, Matthew D.; Rosenberg, Jonathan E.; Bellmunt, Joaquim; Powles, Thomas; Recine, Federica; Harshman, Lauren C.; Chowdhury, Simon; Niegisch, Guenter; Yu, Evan Y.; Pal, Sumanta K.; De Giorgi, Ugo; Crabb, Simon J.; Caubet, Matthieu; Balssa, Loïc; Milowsky, Matthew I.; Ladoire, Sylvain; Créhange, Gilles.

In: Acta Oncologica, 29.08.2017, p. 1-7.

Research output: Contribution to journalArticle

Boustani, J, Bertaut, A, Galsky, MD, Rosenberg, JE, Bellmunt, J, Powles, T, Recine, F, Harshman, LC, Chowdhury, S, Niegisch, G, Yu, EY, Pal, SK, De Giorgi, U, Crabb, SJ, Caubet, M, Balssa, L, Milowsky, MI, Ladoire, S & Créhange, G 2017, 'Radical cystectomy or bladder preservation with radiochemotherapy in elderly patients with muscle-invasive bladder cancer: Retrospective International Study of Cancers of the Urothelial Tract (RISC) Investigators', Acta Oncologica, pp. 1-7. https://doi.org/10.1080/0284186X.2017.1369565
Boustani, Jihane ; Bertaut, Aurélie ; Galsky, Matthew D. ; Rosenberg, Jonathan E. ; Bellmunt, Joaquim ; Powles, Thomas ; Recine, Federica ; Harshman, Lauren C. ; Chowdhury, Simon ; Niegisch, Guenter ; Yu, Evan Y. ; Pal, Sumanta K. ; De Giorgi, Ugo ; Crabb, Simon J. ; Caubet, Matthieu ; Balssa, Loïc ; Milowsky, Matthew I. ; Ladoire, Sylvain ; Créhange, Gilles. / Radical cystectomy or bladder preservation with radiochemotherapy in elderly patients with muscle-invasive bladder cancer : Retrospective International Study of Cancers of the Urothelial Tract (RISC) Investigators. In: Acta Oncologica. 2017 ; pp. 1-7.
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abstract = "Background: Radical cystectomy (RC) and radiochemotherapy (RCT) are curative options for muscle-invasive bladder cancer (MIBC). Optimal treatment strategy remains unclear in elderly patients. Material and methods: Patients aged 80 years old and above with T2-T4aN0-2M0-Mx MIBC were identified in the Retrospective International Study of Cancers of the Urothelial Tract (RISC) database. Patients treated with RC were compared with those treated with RCT. The impact of surgery on overall survival (OS) was assessed using a Cox proportional hazard model. Progression included locoregional and metastatic relapse and was considered a time-dependent variable. Results: Between 1988 and 2015, 92 patients underwent RC and 72 patients had RCT. Median age was 82.5 years (range 80–100) and median follow-up was 2.90 years (range 0.04–11.10). Median OS was 1.99 years (95{\%}CI 1.17–2.76) after RC and 1.97 years (95{\%}CI 1.35–2.64) after RCT (p = .73). Median progression-free survival (PFS) after RC and RCT were 1.25 years (95{\%}CI 0.80–1.75) and 1.52 years (95{\%}CI 1.01–2.04), respectively (p = .54). In multivariate analyses, only disease progression was significantly associated with worse OS (HR = 10.27 (95{\%}CI 6.63–15.91), p < .0001). Treatment modality was not a prognostic factor. Conclusions: RCT offers survival rates comparable to those observed with RC for patients aged ≥80 years.",
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T1 - Radical cystectomy or bladder preservation with radiochemotherapy in elderly patients with muscle-invasive bladder cancer

T2 - Retrospective International Study of Cancers of the Urothelial Tract (RISC) Investigators

AU - Boustani, Jihane

AU - Bertaut, Aurélie

AU - Galsky, Matthew D.

AU - Rosenberg, Jonathan E.

AU - Bellmunt, Joaquim

AU - Powles, Thomas

AU - Recine, Federica

AU - Harshman, Lauren C.

AU - Chowdhury, Simon

AU - Niegisch, Guenter

AU - Yu, Evan Y.

AU - Pal, Sumanta K.

AU - De Giorgi, Ugo

AU - Crabb, Simon J.

AU - Caubet, Matthieu

AU - Balssa, Loïc

AU - Milowsky, Matthew I.

AU - Ladoire, Sylvain

AU - Créhange, Gilles

PY - 2017/8/29

Y1 - 2017/8/29

N2 - Background: Radical cystectomy (RC) and radiochemotherapy (RCT) are curative options for muscle-invasive bladder cancer (MIBC). Optimal treatment strategy remains unclear in elderly patients. Material and methods: Patients aged 80 years old and above with T2-T4aN0-2M0-Mx MIBC were identified in the Retrospective International Study of Cancers of the Urothelial Tract (RISC) database. Patients treated with RC were compared with those treated with RCT. The impact of surgery on overall survival (OS) was assessed using a Cox proportional hazard model. Progression included locoregional and metastatic relapse and was considered a time-dependent variable. Results: Between 1988 and 2015, 92 patients underwent RC and 72 patients had RCT. Median age was 82.5 years (range 80–100) and median follow-up was 2.90 years (range 0.04–11.10). Median OS was 1.99 years (95%CI 1.17–2.76) after RC and 1.97 years (95%CI 1.35–2.64) after RCT (p = .73). Median progression-free survival (PFS) after RC and RCT were 1.25 years (95%CI 0.80–1.75) and 1.52 years (95%CI 1.01–2.04), respectively (p = .54). In multivariate analyses, only disease progression was significantly associated with worse OS (HR = 10.27 (95%CI 6.63–15.91), p < .0001). Treatment modality was not a prognostic factor. Conclusions: RCT offers survival rates comparable to those observed with RC for patients aged ≥80 years.

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