TY - JOUR
T1 - Survival After Partial Cystectomy for Variant Histology Bladder Cancer Compared With Urothelial Carcinoma: A Population-based Study
T2 - Clinical Genitourinary Cancer
AU - Luzzago, S.
AU - Palumbo, C.
AU - Rosiello, G.
AU - Knipper, S.
AU - Pecoraro, A.
AU - Deuker, M.
AU - Mistretta, F.A.
AU - Tian, Z.
AU - Musi, G.
AU - Montanari, E.
AU - Shariat, S.F.
AU - Saad, F.
AU - Briganti, A.
AU - de Cobelli, O.
AU - Karakiewicz, P.I.
N1 - Export Date: 20 May 2020
Correspondence Address: Luzzago, S.; Department of Urology, European Institute of Oncology, Via Giuseppe Ripamonti, 435, Italy; email: stefanoluzzago@gmail.com
PY - 2020
Y1 - 2020
N2 - Background: The present study tested cancer-specific (CSM) and overall mortality (OM) after partial cystectomy (PC) for variant histology bladder cancer (non–urothelial carcinoma of the urinary bladder UCUB), relative to UCUB and relative to radical cystectomy (RC). Materials and Methods: Within the Surveillance, Epidemiology, and End Results registry (2001-2016), we identified patients with stage T1-T2N0M0 non-UCUB and UCUB who had undergone PC or RC. Non-UCUB included adenocarcinoma, squamous carcinoma, neuroendocrine carcinoma, and other histologic subtypes. First, CSM and OM after PC were compared between the non-UCUB and UCUB groups. Second, CSM and OM after PC were compared with RC in the non-UCUB group. Kaplan Meier plots and multivariable Cox regression models were used before and after inverse probability of treatment weighting. Results: Overall, 248 patients (16.3%) treated with PC had had non-UCUB. Of the 248 cases, 115 (46.5%), 50 (20%), 34 (14%), and 49 (19.5%) were adenocarcinoma, squamous carcinoma, neuroendocrine carcinoma, and other histologic subtypes, respectively. The comparison between PC in the non-UCUB and PC in the UCUB group showed higher CSM (hazard ratio, 1.4; P = .03) but the same OM rates (hazard ratio, 1.1; P = .7) in the non-UCUB group. The comparison between PC and RC for the non-UCUB group showed no CSM or OM differences. Conclusions: PC for non-UCUB was associated with higher CSM compared with PC for UCUB. However, PC instead of RC for select patients with non-UCUB appears not to undermine cancer-control outcomes. Thus, the excess CSM is probably unrelated to cystectomy type but could originate from differences in the tumor biology. These results could act as hypothesis generating for the design of future trials.
AB - Background: The present study tested cancer-specific (CSM) and overall mortality (OM) after partial cystectomy (PC) for variant histology bladder cancer (non–urothelial carcinoma of the urinary bladder UCUB), relative to UCUB and relative to radical cystectomy (RC). Materials and Methods: Within the Surveillance, Epidemiology, and End Results registry (2001-2016), we identified patients with stage T1-T2N0M0 non-UCUB and UCUB who had undergone PC or RC. Non-UCUB included adenocarcinoma, squamous carcinoma, neuroendocrine carcinoma, and other histologic subtypes. First, CSM and OM after PC were compared between the non-UCUB and UCUB groups. Second, CSM and OM after PC were compared with RC in the non-UCUB group. Kaplan Meier plots and multivariable Cox regression models were used before and after inverse probability of treatment weighting. Results: Overall, 248 patients (16.3%) treated with PC had had non-UCUB. Of the 248 cases, 115 (46.5%), 50 (20%), 34 (14%), and 49 (19.5%) were adenocarcinoma, squamous carcinoma, neuroendocrine carcinoma, and other histologic subtypes, respectively. The comparison between PC in the non-UCUB and PC in the UCUB group showed higher CSM (hazard ratio, 1.4; P = .03) but the same OM rates (hazard ratio, 1.1; P = .7) in the non-UCUB group. The comparison between PC and RC for the non-UCUB group showed no CSM or OM differences. Conclusions: PC for non-UCUB was associated with higher CSM compared with PC for UCUB. However, PC instead of RC for select patients with non-UCUB appears not to undermine cancer-control outcomes. Thus, the excess CSM is probably unrelated to cystectomy type but could originate from differences in the tumor biology. These results could act as hypothesis generating for the design of future trials.
KW - Adenocarcinoma
KW - Inverse probability of treatment weighting
KW - Neuroendocrine carcinoma
KW - Other histologic subtypes
KW - Squamous carcinoma
KW - adenocarcinoma
KW - adult
KW - aged
KW - Article
KW - bladder cancer
KW - cancer specific survival
KW - cancer staging
KW - comparative study
KW - cystectomy
KW - descriptive research
KW - female
KW - histology
KW - human
KW - Kaplan Meier method
KW - major clinical study
KW - male
KW - neuroendocrine carcinoma
KW - overall survival
KW - proportional hazards model
KW - squamous cell carcinoma
KW - survival analysis
KW - transitional cell carcinoma
U2 - 10.1016/j.clgc.2019.10.016
DO - 10.1016/j.clgc.2019.10.016
M3 - Article
VL - 18
SP - 117-128.e5
JO - Clin. Genitourin. Cancer
JF - Clin. Genitourin. Cancer
SN - 1558-7673
IS - 2
ER -