Mp22-01 Prognostic Variations Between "Primary" and "Progressive" Muscle-Invasive Bladder Cancer Following Radical Cystectomy: A Novel Propensity Score-Based Multicenter Cohort Study

You have accessJournal of UrologyBladder Cancer: Invasive II (MP22)1 May 2024MP22-01 PROGNOSTIC VARIATIONS BETWEEN "PRIMARY" AND "PROGRESSIVE" MUSCLE-INVASIVE BLADDER CANCER FOLLOWING RADICAL CYSTECTOMY: A NOVEL PROPENSITY SCORE-BASED MULTICENTER COHORT STUDY Shicong Lai, Jianyong Liu, Haopu Hu, Samuel Seery, Hao Hu, and Tao Xu Shicong LaiShicong Lai , Jianyong LiuJianyong Liu , Haopu HuHaopu Hu , Samuel SeerySamuel Seery , Hao HuHao Hu , and Tao XuTao Xu View All Author Informationhttps://doi.org/10.1097/01.JU.0001008608.50694.4b.01AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Among muscle-invasive bladder cancer (MIBC) patients treated with radical cystectomy two-thirds first present with muscle invasion (otherwise known as 'primary' MIBC). The rest have already progressed from a non-muscle invasive stage and are generally considered 'progressive' MIBC cases. The aim of this study was to assess variations in oncological outcomes between progressive and primary MIBC cases after radical surgery. METHODS: The Surveillance, Epidemiology, and End Results (SEER) database was used to abstract MIBC data following radical cystectomy from 2000-2019. Patients were classified as either 'Primary' MIBC or 'Progressive' MIBC. Baseline characteristics for the two groups were balanced using a propensity score overlap weight (PSOW) technique. Survival differences between the two groups were analyzed using Kaplan-Meier's plots and log-rank tests. Cox's proportional hazard regression was used to assess risk factors associated with overall survival (OS) and cancer-specific survival (CSS). RESULTS: 6,632 MIBC patients were identified in the SEER database. Among them, 83.3% (n=5,658) were considered primary MIBC patients, and 16.7% (n=974) were categorized as progressive MIBC patients. Distribution of baseline covariates, including age, sex, race, T stage, N stage, tumor grade, marital status, and chemotherapy, were well-balanced after PSOWs were applied. After stable PSOW adjustments, Kaplan-Meier survival analysis showed that the CSS for progressive MIBC (hazard ratio HR=1.25, 95% confidence interval CI: 1.12-1.38, p<0.001) was poorer than the primary MIBC group. However, the difference in OS (HR=1.08, 95%CI: 0.99-1.18) was not significant (p=0.073). Multivariate analysis also suggested that patients with progressive MIBC have significantly poorer CSS (HR=1.24, 95%CI: 1.19-1.38, p<0.001) but not OS (HR=1.08, 95%CI: 0.99-1.18, p=0.089), please see Table 1. CONCLUSIONS: CSS for progressive MIBC patients appears worse than for those with primary MIBC. This highlights the need to direct more resources for this patient population and particularly for high-risk cases of non-MIBC, where timely radical surgery will improve patients prognoses. Source of Funding: This work was supported by a grant from Peking University Medicine Sailing Program for Young Scholars' Scientific & Technological Innovation (Grant BMU2023YFJHPY009, EBS number 2127000305) and a Project (RDJP2022-69) Supported By Peking University People's Hospital Research And Development Funds © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e340 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Shicong Lai More articles by this author Jianyong Liu More articles by this author Haopu Hu More articles by this author Samuel Seery More articles by this author Hao Hu More articles by this author Tao Xu More articles by this author Expand All Advertisement PDF downloadLoading ...