Mp77-08 Study on Survival Outcomes Comparing Radical Cystectomy and Chemoradiation in the Older Population With Clinical Node-Positive Bladder Cancer

You have accessJournal of UrologyBladder Cancer: Invasive VI (MP77)1 May 2024MP77-08 STUDY ON SURVIVAL OUTCOMES COMPARING RADICAL CYSTECTOMY AND CHEMORADIATION IN THE OLDER POPULATION WITH CLINICAL NODE-POSITIVE BLADDER CANCER Arjun Pon Avudaiappan, Pushan Prabhakar, Jay Chandar, Ahmed Eldefrawy, Jorge Caso, and Murugesan Manoharan Arjun Pon AvudaiappanArjun Pon Avudaiappan , Pushan PrabhakarPushan Prabhakar , Jay ChandarJay Chandar , Ahmed EldefrawyAhmed Eldefrawy , Jorge CasoJorge Caso , and Murugesan ManoharanMurugesan Manoharan View All Author Informationhttps://doi.org/10.1097/01.JU.0001009404.49693.12.08AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Patients with bladder cancer who have clinical lymph node involvement (cN+) face a higher risk of developing distant metastasis. The recommended treatment options for these patients include neoadjuvant chemotherapy with radical cystectomy (RC) or concurrent chemoradiation (CRT). According to the Surveillance, Epidemiology, and End Results Program, median age of patients at the time of bladder cancer diagnosis is 73 years, and due to the improvement in healthcare and increase in life expectancy, a greater proportion of older adults are undergoing challenging procedures. Therefore, it is essential to understand the survival outcomes among this population. In our study, we used the National Cancer Database and compared the survival outcomes between RC and CRT among the older population with cN+ bladder cancer. METHODS: Our study was focused on individuals 70 years and above diagnosed with cN+ bladder cancer (cT1-4aN1-3M0) between 2004 and 2018. We divided them into two analytical arms: the RC arm, consisting of patients who underwent RC with or without chemotherapy or radiotherapy, and the CRT arm, consisting of those who received chemotherapy and radiotherapy within 90 days of each other. A propensity-score matching was done using sex, race, ethnicity, facility type, insurance, comorbidity index, clinical T, and clinical N. Later, we performed a Kaplan-Meier survival analysis to analyze the overall survival (OS) outcomes in RC and CRT arms. RESULTS: Out of the initial 7673 individuals diagnosed with cN+ cancer, 1220 individuals met our selection criteria. The RC and CRT arm comprised 959(78.6%) and 261(21.4%) patients, respectively. In the RC arm, 525(54.5%) underwent RC in academic centers, whereas within the CRT arm, 120(46%) underwent CRT in community health centers (p<0.001). After matching, each treatment arm consisted of 218 patients, and the median OS was 20 months (95% CI, 17.6-22.2) in the RC arm and 14.4 months (95% CI, 11.93-17.0) in the CRT arm (p<0.001). CONCLUSIONS: In our study, we focused on older adults with cN+ bladder cancer and observed that RC had favorable survival outcomes compared to CRT. This information could be valuable in facilitating patient counselling and promoting shared decision-making. 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 Ahmed Eldefrawy More articles by this author Jorge Caso More articles by this author Murugesan Manoharan More articles by this author Expand All Advertisement PDF downloadLoading ...