Introduction: We investigated the effect of partial cystectomy (PC) on cancer-specific mortality (CSM) and other-cause mortality (OCM) and the effect of pelvic lymph node dissection (PLND) during PC on CSM. Materials and Methods: Within the Surveillance, Epidemiology, and End Results database (2004-2015), 11,429 cases of nonmetastatic stage pT2-T3 urothelial carcinoma of the urinary bladder treated with either PC or radical cystectomy (RC) were identified. All comparisons between PC and RC relied on propensity score (PS; ratio, 1:1) adjusted univariable and multivariable logistic and competing risks regression models. In contrast, all comparisons between PLND and no PLND at PC relied on inverse probability of treatment weighting-adjusted univariable and multivariable Cox regression models. Results: Within the SEER database, PC had been performed in 979 patients (8.6%). The PC annual rates decreased from 11.0% to 6.8% during the study period (P < .001). In PS-adjusted multivariable analyses focusing on CSM and OCM, no statistically significant difference between the PC and RC groups (P = .2 and P = .3, respectively). The annual PLND rates with PC (50.3%) did not vary over time (P = .3). In the overall cohort and the PC subgroup, PLND was associated with a lower CSM rate (hazard ratio, 0.56; P < .001; and hazard ratio, 0.57; P < .001, respectively). Conclusions: A small proportion of patients with stage pT2-T3 urothelial carcinoma of the urinary bladder were candidates for PC. In the PS-adjusted multivariable analyses, no statistically significant differences were found in CSM or OCM between the PC and RC groups. Within the PC group, PLND had been omitted 50% of the time despite its association with lower CSM.
Partial Cystectomy With Pelvic Lymph Node Dissection for Patients With Nonmetastatic Stage pT2-T3 Urothelial Carcinoma of Urinary Bladder: Temporal Trends and Survival Outcomes / F.A. Mistretta, S.-. Cyr, S. Luzzago, E. Mazzone, S. Knipper, C. Palumbo, Z. Tian, S. Nazzani, F. Saad, E. Montanari, D. Tilki, A. Briganti, S.F. Shariat, O. de Cobelli, P.I. Karakiewicz. - In: CLINICAL GENITOURINARY CANCER. - ISSN 1558-7673. - 18:2(2020), pp. 129-137.
|Titolo:||Partial Cystectomy With Pelvic Lymph Node Dissection for Patients With Nonmetastatic Stage pT2-T3 Urothelial Carcinoma of Urinary Bladder: Temporal Trends and Survival Outcomes|
MISTRETTA, FRANCESCO ALESSANDRO (Primo) (Corresponding)
DE COBELLI, OTTAVIO (Penultimo)
|Parole Chiave:||Cystectomy; Lymph node excision; Mortality; SEER program; Urinary bladder neoplasms|
|Settore Scientifico Disciplinare:||Settore MED/24 - Urologia|
|Data di pubblicazione:||2020|
|Digital Object Identifier (DOI):||http://dx.doi.org/10.1016/j.clgc.2019.09.008|
|Appare nelle tipologie:||01 - Articolo su periodico|