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

被引:19
作者
Boustani, Jihane [1 ]
Bertaut, Aurelie [2 ]
Galsky, Matthew D. [3 ]
Rosenberg, Jonathan E. [4 ]
Bellmunt, Joaquim [5 ]
Powles, Thomas [6 ]
Recine, Federica [7 ]
Harshman, Lauren C. [8 ]
Chowdhury, Simon [9 ]
Niegisch, Guenter [10 ]
Yu, Evan Y. [11 ]
Pal, Sumanta K. [12 ]
De Giorgi, Ugo [7 ]
Crabb, Simon J. [13 ]
Caubet, Matthieu [1 ]
Balssa, Loic [1 ]
Milowsky, Matthew I. [14 ]
Ladoire, Sylvain [15 ]
Crehange, Gilles [16 ]
机构
[1] Univ Hosp Besancon, Dept Radiat Oncol, 3 Blvd A Fleming, F-25000 Besancon, France
[2] Univ Burgundy, Dept Biostat, Georges Francois Leclerc Ctr, Dijon, France
[3] Icahn Sch Med Mt Sinai, New York, NY 10029 USA
[4] Mem Sloan Kettering Canc Ctr, 1275 York Ave, New York, NY 10021 USA
[5] Harvard Med Sch, Dana Farber Canc Inst, Lank Ctr Genitourinary Oncol, Boston, MA USA
[6] Queen Mary Univ London, Barts Canc Inst ECMC, Barts Hlth & Royal Free NHS Trust, London, England
[7] Ist Sci Romagnolo Studio & Cura Tumori IRST IRCCS, Dept Med Oncol, Meldola, Italy
[8] Dana Farber Canc Inst, Dept Med Oncol, Boston, MA 02115 USA
[9] Guys & St Thomas Hosp, London, England
[10] Heinrich Heine Univ, Dusseldorf, Germany
[11] Fred Hutchinson Canc Res Ctr, 1124 Columbia St, Seattle, WA 98104 USA
[12] City Hope Comprehens Canc Ctr, Duarte, CA USA
[13] Southampton Gen Hosp, Dept Med Oncol, Southampton, Hants, England
[14] Univ North Carolina Chapel Hill, Lineberger Comprehens Canc Ctr, Chapel Hill, NC USA
[15] Univ Burgundy, Dept Med Oncol, Georges Francois Leclerc Canc Ctr, Dijon, France
[16] Univ Burgundy, Dept Radiat Oncol, Georges Francois Leclerc Canc Ctr, Dijon, France
关键词
COMBINED-MODALITY THERAPY; LONG-TERM OUTCOMES; SURVIVAL; NEOADJUVANT; AGE;
D O I
10.1080/0284186X.2017.1369565
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
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.
引用
收藏
页码:491 / 497
页数:7
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