Stage pT0 at radical cystectomy confers improved survival

An international study of 4,430 patients

Derya Tilki, Robert S. Svatek, Giacomo Novara, Michael Seitz, Guilherme Godoy, Pierre I. Karakiewicz, Wassim Kassouf, Yves Fradet, Hans Martin Fritsche, Guru Sonpavde, Jonathan I. Izawa, Vincenzo Ficarra, Seth P. Lerner, Mark Schoenberg, Christian G. Stief, Colin P. Dinney, Eila Skinner, Yair Lotan, Arthur I. Sagalowsky, Oliver Reich & 1 others Shahrokh F. Shariat

Research output: Contribution to journalArticle

Abstract

Purpose: We describe the cancer related outcome in patients with pT0 bladder urothelial carcinoma at radical cystectomy who did not receive preoperative chemotherapy in a large multicenter series. We also compared outcomes in patients with pT0 bladder urothelial carcinoma to those in patients with other stages and assessed the effect of clinical stage on outcome. Materials and Methods: We reviewed the records of 4,430 patients treated with radical cystectomy for bladder urothelial carcinoma without neoadjuvant chemotherapy at 12 centers in the United States, Canada and Europe. Results: Of the patients 228 (5.1%) had pT0 disease at radical cystectomy. Clinical stage was cTa or cTis in 13.6% and cT1 in 29.8% of these patients, and disease was muscle invasive (cT2-4a) in 56.2%. Metastasis developed to regional lymph nodes in 17 cases (7.5%). At a median 48.2-month followup 15 patients (6.6%) had died of bladder cancer. Five-year recurrence-free and cancer specific survival estimates were 89.7% (95% CI 85.3-93.1) and 93.1% (95% CI 88.9-95.6), respectively. Disease-free and cancer specific survival in pT0 cases was similar to that in pTa/pTis cases but significantly better than in pT1 or pT2 cases. On multivariate analysis increased disease recurrence and cancer specific mortality risks were significantly associated with lymph node metastasis (each p

Original languageEnglish (US)
Pages (from-to)888-894
Number of pages7
JournalJournal of Urology
Volume184
Issue number3
DOIs
StatePublished - Sep 2010

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Cystectomy
Survival
Urinary Bladder
Carcinoma
Neoplasms
Lymph Nodes
Neoplasm Metastasis
Recurrence
Drug Therapy
Urinary Bladder Neoplasms
Canada
Multivariate Analysis
Muscles
Mortality

Keywords

  • carcinoma
  • cystectomy
  • mortality
  • urinary bladder
  • urothelium

ASJC Scopus subject areas

  • Urology
  • Medicine(all)

Cite this

Tilki, D., Svatek, R. S., Novara, G., Seitz, M., Godoy, G., Karakiewicz, P. I., ... Shariat, S. F. (2010). Stage pT0 at radical cystectomy confers improved survival: An international study of 4,430 patients. Journal of Urology, 184(3), 888-894. https://doi.org/10.1016/j.juro.2010.04.081

Stage pT0 at radical cystectomy confers improved survival : An international study of 4,430 patients. / Tilki, Derya; Svatek, Robert S.; Novara, Giacomo; Seitz, Michael; Godoy, Guilherme; Karakiewicz, Pierre I.; Kassouf, Wassim; Fradet, Yves; Fritsche, Hans Martin; Sonpavde, Guru; Izawa, Jonathan I.; Ficarra, Vincenzo; Lerner, Seth P.; Schoenberg, Mark; Stief, Christian G.; Dinney, Colin P.; Skinner, Eila; Lotan, Yair; Sagalowsky, Arthur I.; Reich, Oliver; Shariat, Shahrokh F.

In: Journal of Urology, Vol. 184, No. 3, 09.2010, p. 888-894.

Research output: Contribution to journalArticle

Tilki, D, Svatek, RS, Novara, G, Seitz, M, Godoy, G, Karakiewicz, PI, Kassouf, W, Fradet, Y, Fritsche, HM, Sonpavde, G, Izawa, JI, Ficarra, V, Lerner, SP, Schoenberg, M, Stief, CG, Dinney, CP, Skinner, E, Lotan, Y, Sagalowsky, AI, Reich, O & Shariat, SF 2010, 'Stage pT0 at radical cystectomy confers improved survival: An international study of 4,430 patients', Journal of Urology, vol. 184, no. 3, pp. 888-894. https://doi.org/10.1016/j.juro.2010.04.081
Tilki, Derya ; Svatek, Robert S. ; Novara, Giacomo ; Seitz, Michael ; Godoy, Guilherme ; Karakiewicz, Pierre I. ; Kassouf, Wassim ; Fradet, Yves ; Fritsche, Hans Martin ; Sonpavde, Guru ; Izawa, Jonathan I. ; Ficarra, Vincenzo ; Lerner, Seth P. ; Schoenberg, Mark ; Stief, Christian G. ; Dinney, Colin P. ; Skinner, Eila ; Lotan, Yair ; Sagalowsky, Arthur I. ; Reich, Oliver ; Shariat, Shahrokh F. / Stage pT0 at radical cystectomy confers improved survival : An international study of 4,430 patients. In: Journal of Urology. 2010 ; Vol. 184, No. 3. pp. 888-894.
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abstract = "Purpose: We describe the cancer related outcome in patients with pT0 bladder urothelial carcinoma at radical cystectomy who did not receive preoperative chemotherapy in a large multicenter series. We also compared outcomes in patients with pT0 bladder urothelial carcinoma to those in patients with other stages and assessed the effect of clinical stage on outcome. Materials and Methods: We reviewed the records of 4,430 patients treated with radical cystectomy for bladder urothelial carcinoma without neoadjuvant chemotherapy at 12 centers in the United States, Canada and Europe. Results: Of the patients 228 (5.1{\%}) had pT0 disease at radical cystectomy. Clinical stage was cTa or cTis in 13.6{\%} and cT1 in 29.8{\%} of these patients, and disease was muscle invasive (cT2-4a) in 56.2{\%}. Metastasis developed to regional lymph nodes in 17 cases (7.5{\%}). At a median 48.2-month followup 15 patients (6.6{\%}) had died of bladder cancer. Five-year recurrence-free and cancer specific survival estimates were 89.7{\%} (95{\%} CI 85.3-93.1) and 93.1{\%} (95{\%} CI 88.9-95.6), respectively. Disease-free and cancer specific survival in pT0 cases was similar to that in pTa/pTis cases but significantly better than in pT1 or pT2 cases. On multivariate analysis increased disease recurrence and cancer specific mortality risks were significantly associated with lymph node metastasis (each p",
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AU - Dinney, Colin P.

AU - Skinner, Eila

AU - Lotan, Yair

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AU - Reich, Oliver

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