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Characterization of late recurrence after radical cystectomy in a large multicenter cohort of bladder cancer patients
EAU16th Central European Meeting, 7-8 October 2016, Vienna, Austria
98
Characterization of late recurrence after radical cystectomy in a large multicenter cohort of bladder cancer patients Eur Urol Suppl 2016; 15(11);e1471
Soria F.1, Moschini M.1, Wirth G.J.1, Gust K.M.1, Klatte T.1, Briganti A.2, Gontero P.3, Abufaraj M.1, Özsoy M.1, Karakiewicz P.I.4, Shariat S.F.1 1
Medical University of Vienna, Dept. of Urology, Vienna, Austria, 2Urological Research Institute, VitaSalute University, San Raffaele Scientific Institute, Dept. of Urology, Milan, Italy, 3San Giovanni Battista Hospital, University of Studies of Torino, Dept. of Urology, Turin, Italy, 4University of Montreal, Dept. of Urology, Montreal, Canada INTRODUCTION & OBJECTIVES: To investigate the characteristics and outcomes of late recurrence (LR) in bladder cancer (BCa) patients treated with radical cystectomy (RC) and to identify clinicopathologic predictors of LR and post-recurrence survival. MATERIAL & METHODS: This retrospective multicenter study included 1652 BCa patients treated with radical RC. LR was defined as occurring more than 5 years after RC. Survival was estimated with the Kaplan Meier method and differences in post-recurrence overall survival according to the timing of disease recurrence and to the location of recurrence were calculated using the log rank test. Logistic regression model was used to identify predictors of LR and Cox proportional hazard regression models to evaluate variables associated with post-recurrence overall mortality. RESULTS: Overall, 548 patients experienced disease recurrence. Of these, 67 patients (12.2%) experienced LR, with a median time to recurrence of 68 months (IQR 70.5-107.2). LR was more likely to be located in the urothelium when compared to early recurrence (ER) (p=0.005). On multivariable logistic regression analysis, younger age (p=0.008) and non-organ confined disease (p=0.03) were found to be predictors of LR. Post-recurrence 5-years overall survival (OS) was worse in patients who experienced ER compared to those with LR (12% vs 25%, p=0.02) and in those with non-urothelial recurrence compared to those with disease-recurrence in the remaining urothelium (12% vs 51%, p<0.001). Older age (p<0.001), non-organ confined disease at RC (p=0.02) and non-urothelial recurrence site (p=0.002), but not ER (p=0.07), were independently associated with post-recurrence OS. CONCLUSIONS: LR after RC is an uncommon but not negligible event that harbours unique characteristics. LR is associated with better OS compared to ER. Our findings reinforce the need to follow-up BCa patients life-long after RC.
Eur Urol Suppl 2016; 15(11);e1471 Powered by TCPDF (www.tcpdf.org)
98
Characterization of late recurrence after radical cystectomy in a large multicenter cohort of bladder cancer patients Eur Urol Suppl 2016; 15(11);e1471
Soria F.1, Moschini M.1, Wirth G.J.1, Gust K.M.1, Klatte T.1, Briganti A.2, Gontero P.3, Abufaraj M.1, Özsoy M.1, Karakiewicz P.I.4, Shariat S.F.1 1
Medical University of Vienna, Dept. of Urology, Vienna, Austria, 2Urological Research Institute, VitaSalute University, San Raffaele Scientific Institute, Dept. of Urology, Milan, Italy, 3San Giovanni Battista Hospital, University of Studies of Torino, Dept. of Urology, Turin, Italy, 4University of Montreal, Dept. of Urology, Montreal, Canada INTRODUCTION & OBJECTIVES: To investigate the characteristics and outcomes of late recurrence (LR) in bladder cancer (BCa) patients treated with radical cystectomy (RC) and to identify clinicopathologic predictors of LR and post-recurrence survival. MATERIAL & METHODS: This retrospective multicenter study included 1652 BCa patients treated with radical RC. LR was defined as occurring more than 5 years after RC. Survival was estimated with the Kaplan Meier method and differences in post-recurrence overall survival according to the timing of disease recurrence and to the location of recurrence were calculated using the log rank test. Logistic regression model was used to identify predictors of LR and Cox proportional hazard regression models to evaluate variables associated with post-recurrence overall mortality. RESULTS: Overall, 548 patients experienced disease recurrence. Of these, 67 patients (12.2%) experienced LR, with a median time to recurrence of 68 months (IQR 70.5-107.2). LR was more likely to be located in the urothelium when compared to early recurrence (ER) (p=0.005). On multivariable logistic regression analysis, younger age (p=0.008) and non-organ confined disease (p=0.03) were found to be predictors of LR. Post-recurrence 5-years overall survival (OS) was worse in patients who experienced ER compared to those with LR (12% vs 25%, p=0.02) and in those with non-urothelial recurrence compared to those with disease-recurrence in the remaining urothelium (12% vs 51%, p<0.001). Older age (p<0.001), non-organ confined disease at RC (p=0.02) and non-urothelial recurrence site (p=0.002), but not ER (p=0.07), were independently associated with post-recurrence OS. CONCLUSIONS: LR after RC is an uncommon but not negligible event that harbours unique characteristics. LR is associated with better OS compared to ER. Our findings reinforce the need to follow-up BCa patients life-long after RC.
Eur Urol Suppl 2016; 15(11);e1471 Powered by TCPDF (www.tcpdf.org)