History of Non–Muscle-Invasive Bladder Cancer May Have a Worse Prognostic Impact in cT2-4aN0M0 Bladder Cancer Patients Treated With Radical Cystectomy

Emina Kayama, Eiji Kikuchi, Keishiro Fukumoto, Suguru Shirotake, Yasumasa Miyazaki, Kyohei Hakozaki, Gou Kaneko, Shunsuke Yoshimine, Nobuyuki Tanaka, Maeda Takahiro, Kunimitsu Kanai, Masafumi Oyama, Yosuke Nakajima, Satoshi Hara, Tetsuo Monma, Mototsugu Oya

研究成果: Article

1 引用 (Scopus)

抜粋

We performed a retrospective study comparing clinical outcomes between patients with initially diagnosed muscle-invasive bladder cancer (MIBC) without a history of non-MIBC (NMIBC) and those with MIBC that progressed from NMIBC. A history of NMIBC was independently associated with cancer death in cT2-T4a MIBC patients treated with radical cystectomy and without lymph node involvement. MIBC that progresses from NMIBC may not respond to neoadjuvant chemotherapy. Purpose: To investigate whether a history of non–muscle-invasive bladder cancer (NMIBC) plays a prognostic role in patients with muscle-invasive bladder cancer (MIBC) treated with radical cystectomy in the era when neoadjuvant chemotherapy was established as standard therapy for MIBC. Patients and Methods: A total of 282 patients who were diagnosed with cT2-T4aN0M0 bladder cancer treated with open radical cystectomy at our institutions were included. Initially diagnosed MIBC without a history of NMIBC was defined as primary MIBC group (n = 231), and MIBC that progressed from NMIBC was defined as progressive MIBC (n = 51). Results: The rate of cT3/4a tumors was significantly higher in the primary MIBC group than in the progressive MIBC group (P =.004). Five-year recurrence-free survival and cancer-specific survival (CSS) rates for the primary MIBC group versus progressive MIBC group were 68.2% versus 55.9% (P =.039) and 76.1% versus 61.6% (P =.005), respectively. Progressive MIBC (hazard ratio, 2.170; P =.008) was independently associated with cancer death. In the primary MIBC group, the 5-year CSS rate in patients treated with neoadjuvant chemotherapy was 85.4%, which was significantly higher than that in patients without (71.5%, P =.023). In the progressive MIBC group, no significant differences were observed in CSS between patients treated with and without neoadjuvant chemotherapy. Conclusion: MIBC that progressed from NMIBC had a significantly worse clinical outcome than MIBC without a history of NMIBC and may not respond as well to neoadjuvant chemotherapy. These results are informative, even for NMIBC patients treated with conservative intravesical therapy.

元の言語English
ページ(範囲)e969-e976
ジャーナルClinical Genitourinary Cancer
16
発行部数5
DOI
出版物ステータスPublished - 2018 10

ASJC Scopus subject areas

  • Oncology
  • Urology

フィンガープリント History of Non–Muscle-Invasive Bladder Cancer May Have a Worse Prognostic Impact in cT2-4aN0M0 Bladder Cancer Patients Treated With Radical Cystectomy' の研究トピックを掘り下げます。これらはともに一意のフィンガープリントを構成します。

  • これを引用

    Kayama, E., Kikuchi, E., Fukumoto, K., Shirotake, S., Miyazaki, Y., Hakozaki, K., Kaneko, G., Yoshimine, S., Tanaka, N., Takahiro, M., Kanai, K., Oyama, M., Nakajima, Y., Hara, S., Monma, T., & Oya, M. (2018). History of Non–Muscle-Invasive Bladder Cancer May Have a Worse Prognostic Impact in cT2-4aN0M0 Bladder Cancer Patients Treated With Radical Cystectomy. Clinical Genitourinary Cancer, 16(5), e969-e976. https://doi.org/10.1016/j.clgc.2018.04.004