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PREDICTORS IN PATIENTS WITH MUSCLE-INVASIVE BLADDER CANCER AFTER RADICAL CYSTECTOMY

https://doi.org/10.17650/1726-9776-2014-10-2-29-34

Abstract

Purpose. Assessment of predictors of cancer-specific survival (CSS) in patients at high risk of progression of muscle-invasive bladder cancer (MIBC) after radical cystectomy that have been included in a prospective, randomized study to assess efficacy of shortened course of adjuvant chemotherapy.

Material and methods. A total of 92 patients were included in the study. Prognostic significance of age, gender, recurrent status of urinary diversion, pT category and pN, the number of distant lymph nodes (LN), the degree of differentiation and the presence of metaplasia, the number of metastatic lesions of the LN and LN-density lesion on CSS were evaluated with Cox proportional hazard model.

Results. Factors significantly associated with the probability of death from bladder cancer were number of metastatic lymph nodes (hazard ratio (HR) 1.128; 95 % confidence interval (CI) 1.018–1.251; p = 0.022) and the density of LN involvement (HR 1.011; 95 % CI 1.001–1.022; p = 0.039).

About the Authors

A. G. Zhegalik
N.N. Aleksandrov Republican Scientific-and-Practical Center of Oncology and Medical Radiology, Minsk
Belarus


S. L. Polyakov
N.N. Aleksandrov Republican Scientific-and-Practical Center of Oncology and Medical Radiology, Minsk
Belarus


A. I. Rolevich
N.N. Aleksandrov Republican Scientific-and-Practical Center of Oncology and Medical Radiology, Minsk
Belarus


References

1. Красный С.А. Лечение больных инвазив-ным раком мочевого пузыря. Автореф. дис. … д-ра мед. наук. Минск, 2007. 39 с.

2. Матвеев Б.П., Фигурин К.М., Карякин О.Б. Рак мочевого пузыря. М.: Вердана, 2001. 243 с.

3. Hautmann R.E., De Petriconi R., Gottfried H.W. et al. The ileal neobladder: complications and functional results in 363 patients after 11 years of followup. J Urol 1999:161(2):422–7.

4. Stein J.P., Lieskovsky G., Cote R. et al. Radical cystectomy in the treatment of invasive bladder cancer: long-term results in 1054 patients. J Clin Oncol 2001;19:666–775.

5. Herr H.W. Superiority of ratio based lymph node staging for bladder cancer. J Urol 2003;169:943–5.

6. Herr H.W., Faulkner J.R., Grossman H.B. et al. Surgical factors influence bladder cancer outcomes: a cooperative group report. J Clin Oncol 2004; 22:2781–9.

7. Adjuvant chemotherapy in invasive bladder cancer: a systematic review and meta-analysis of individual patientdata Advanced Bladder Cancer (ABC) Meta-analysis Collaboration. Eur Urol 2005;48(2):189–99.

8. Studer U.E., Bacchi M., Biedermann C. et al. Adjuvant cisplatin chemotherapy following cystectomy for bladder cancer: results of a prospective randomised trial. J Urol 1994;152:81–4.

9. Grossman H.B., Natale R.B., Tangen C.M. et al. Neoadjuvant chemotherapy plus cystectomy compared with cystectomy alone for locally advanced bladder cancer. N Engl J Med 2003;349:859–66.

10. Roberts J.T., von der Maase H., Sengelov L. et al. Long-term survival results of a randomized trial comparing gemcitabine/ cisplatin and methotrexate/vinblastine/doxorubicin/cisplatin in patients with locally advanced and metastatic bladder cancer. Ann Oncol 2006;Suppl 5:118–22.

11. Skinner D.G., Daniels J.R., Russel C.A. et al. Adjuvant chemotherapy following cystectomy benefits patients with deeply invasive bladder cancer. Semi Urol 1990;8(4):279–84.

12. Stockle M., Meyenburg W., Wellek S. et al. Adjuvant polychemotherapy of non-organg confined bladder cancer after radical cystectomy revisited: long term results of a controlled prospective study and further clinical experience. J Urol 1995;153:47–52.

13. Freiha F., Reese J., Torti F.M. A randomised trial of radical cystectomy versus radical cystectomy plus cisplatin, vinblastine and methotrexate chemotherapy for muscle invasive bladder cancer. J Urol 1996;155:495–500.

14. Bono A.V., Benvenuti C., Gibba A. et al. Adjuvant chemotherapy in locally advanced bladder cancer. Final analysis of a controlled multicentre study. Acta Urol Ital 1997;11(1):5–8.

15. Leissner J., Hohenfellner R., Thuroff J.W. et al. Lymphadenectomy in patients with transitional cell carcinoma of the urinary bladder; significance for staging and prognosis. BJU Int 2000;85:817–823.

16. Abol-Enein H., El-Baz M., Abd El-Hameed M.A. et al. Lymph node involvement in patients with bladder cancer treated with radical cystectomy: a pathoanatomical study a single center experience. J Urol 2004;172:1818–21.

17. Poulsen A.L., Horn T., Steven K. Radical cystectomy: extending the limits of pelvic lymph node dissection improves survival for patients with bladder cancer confined to the bladder wall. J Urol 1998;160:2015–20.

18. Herr H.W. Surgical factors in bladder cancer: more (nodes) + more (pathology) = less (mortality). BJU Int 2003;92:187–188.

19. Konety B.R., Joslyn S.A., O’Donnell M.A. Extent of pelvic lymphadenectomy and its impact on outcome in patients diagnosed with bladder cancer: analysis of data from the Surveillance, Epidemiology and End Results Program data base. J Urol 2003;169:946–50.

20. Dretler S.P., Ragsdale B.D., Leadbetter W.F. The value of pelvic lymphadenectomy in the surgical treatment of bladder cancer. J Urol 1973;109:414–6.

21. Skinner D.G. Management of invasive bladder cancer: a meticulous pelvic lymph node dissection can make a difference. J Urol 1982;128:34–6.

22. Stein J.P., Cai J., Groshen S., Skinner D.G. Risk factors for patients with pelvic lymph node metastases following radical cystectomy with en bloc pelvic lymphadenectomy: the concept of lymph node density. J Urol 2003;170:35–41.

23. Vieweg J., Gschwend J.E., Herr H.W., Fair W.R. Pelvic lymph node dissection can be curative in patients with node positive bladder cancer. J Urol 1999;161:449–54.

24. Abdel-Latif M., Abol-Enein H., El-Baz M., Ghoneim M.A. Nodal involvement in bladder cancer cases treated with radical cystectomy: incidence and prognosis. J Urol 2004;172:85–8.

25. Stein J.P., Cai J., Groshen S., Skinner D.G. Risk factors for patients with pelvic lymph node metastases following radical cystectomy with en bloc pelvic lymphadenectomy: the concept of lymph node density. J Urol 2003;170:35–41.


Review

For citations:


Zhegalik A.G., Polyakov S.L., Rolevich A.I. PREDICTORS IN PATIENTS WITH MUSCLE-INVASIVE BLADDER CANCER AFTER RADICAL CYSTECTOMY. Cancer Urology. 2014;10(2):29-34. (In Russ.) https://doi.org/10.17650/1726-9776-2014-10-2-29-34

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ISSN 1726-9776 (Print)
ISSN 1996-1812 (Online)
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