Mp77-09 Comparative Study on Survival Outcomes of Bladder Preservation Strategies in Older Population With Muscle-Invasive Bladder Cancer: Partial Cystectomy vs. Chemoradiation

You have accessJournal of UrologyBladder Cancer: Invasive VI (MP77)1 May 2024MP77-09 COMPARATIVE STUDY ON SURVIVAL OUTCOMES OF BLADDER PRESERVATION STRATEGIES IN OLDER POPULATION WITH MUSCLE-INVASIVE BLADDER CANCER: PARTIAL CYSTECTOMY VS. CHEMORADIATION Arjun Pon Avudaiappan, Pushan Prabhakar, Jay Chandar, Manuel Ozambela, Ahmed Eldefrawy, and Murugesan Manoharan Arjun Pon AvudaiappanArjun Pon Avudaiappan , Pushan PrabhakarPushan Prabhakar , Jay ChandarJay Chandar , Manuel OzambelaManuel Ozambela , Ahmed EldefrawyAhmed Eldefrawy , and Murugesan ManoharanMurugesan Manoharan View All Author Informationhttps://doi.org/10.1097/01.JU.0001009404.49693.12.09AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Radical cystectomy (RC) is the established treatment of care for muscle-invasive bladder cancer (MIBC). There is a growing recognition of bladder preservation strategies because of their satisfactory oncological outcomes. Guidelines suggest concurrent chemoradiation (CRT) as a viable option for localized MIBC. Partial cystectomy (PC) is viewed as a possible alternative for selected patients with T2 bladder cancer. Hence, it is essential to understand the survival outcomes among older individuals treated with PC and CRT. Our study used the National Cancer Database to compare the survival outcomes between PC and CRT among the older population with T2 tumors <5 cm. METHODS: Our study population was individuals aged 70 and above diagnosed with localized MIBC and urothelial histology (cT2-4aN0M0) between 2004 and 2018. These patients were categorized into two primary arms: the PC arm, which included patients who underwent PC with or without chemotherapy or radiotherapy, and the CRT arm, which included patients who received chemotherapy and radiotherapy within 90 days of each other. Once propensity matching with sex, race, ethnicity, median income, education, insurance, comorbidity index, tumor stage, and tumor size was done, we performed a Kaplan-Meier survival analysis to compare the overall survival (OS) outcomes between PC and CRT in patients with T2 tumors <5 cm. RESULTS: Of 58,038 patients diagnosed with MIBC aged 70 years and above, 5,490 of them met our selection criteria. Among them, 1,178 were in the PC arm, and 4,312 were in the CRT arm. Within PC and CRT arm, 247 (42.6%) and 684 (45.6%) were treated in community center, whereas 173 (29.8%) and 332 (22.1%) were treated in academic center (p<0.01). Each arm had 458 patients with T2 tumors <5 cm after propensity-matching. The median OS for the PC arm was 55.3 months (95% CI, 48.4 – 62.1), and for the CRT arm was 34.6 (95% CI, 29.9 – 39.3) months, respectively (p<0.001). CONCLUSIONS: In this study on older individuals with T2 tumors <5 cm, we compared partial cystectomy with chemoradiation and noted that PC had favorable survival outcomes. Hence, PC could be considered as a viable option for treating carefully selected individuals in older population. Download PPT Source of Funding: N/A © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e1255 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Arjun Pon Avudaiappan More articles by this author Pushan Prabhakar More articles by this author Jay Chandar More articles by this author Manuel Ozambela More articles by this author Ahmed Eldefrawy More articles by this author Murugesan Manoharan More articles by this author Expand All Advertisement PDF downloadLoading ...