Clinical characterization of radiation-associated muscle-invasive bladder cancer - 11/08/21
Abstract |
Objective |
To characterize the presentation, patterns of care, and outcomes of radiation-associated muscle-invasive bladder cancer (RA-MIBC) compared to primary (non-radiation associated) MIBC. RA-MIBC has been suggested to represent a more aggressive disease variant and be more difficult to treat compared to primary (non-radiation associated) MIBC.
Methods |
We identified 60,090 patients diagnosed with MIBC between 1988-2015 using the Surveillance, Epidemiology, and End Results database and stratified patients based on whether radiation had been administered to a prior pelvic primary cancer. We used Fine-Gray competing risks regression to compare adjusted bladder cancer-specific mortality (BCSM) for RA-MIBC compared to primary MIBC.
Results |
There were 1,093 patients with RA-MIBC and 58,997 patients with primary MIBC. RA-MIBCs were more likely to be T4 at diagnosis (21.0% vs 17.3%, P < .001), and less likely to be node-positive (10.3% vs 17.1%, P < .001). The rate of 5-year BCSM was significantly higher for patients with RA-MIBC vs primary MIBC (56.1% vs 35.3%, AHR 1.24, P < .001), even after stratification by other tumor, treatment and patient-specific factors.
Conclusion |
RA-MIBCs tended to present with higher grade and T stage disease and were less likely to receive curative treatment. Even when accounting for stage, grade, and receipt of treatment, patients with RA-MIBC had worse survival compared to those with primary MIBC. These findings suggest that RA-MIBC present unique clinical challenges and may also represent a biologically more aggressive disease compared to primary MIBC. Future research is needed to better understand the biology of RA-MIBC and develop improved treatment approaches.
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Funding Support: There was no funding or financial support. |
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Data availability statement: Research data are available at data/. |
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Conflicts of interest: B.A.M. receives funding from the Prostate Cancer Foundation and (PCF) and the American Society for Radiation Oncology (ASTRO). P.L.N. receives support from Bayer, Astellas, Ferring, Dendreon, Blue Earth, Genome Dx, Augmenix, Boston Scientific, Janssen, and Cota Healthcare. G.S. receives support from BMS, Genentech, EMD Serono, Merck, Sanofi, Seattle Genetics/Astellas, Astrazeneca, Exelixis, Janssen, Bicycle Therapeutics, Pfizer, Physician's Education Resource, Onclive, Research to Practice, MedScape, and UptoDate. K.W.M. receives support from Pfizer/EMD Serono. |
Vol 154
P. 208-214 - août 2021 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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