In:
Journal of Clinical Oncology, American Society of Clinical Oncology (ASCO), Vol. 38, No. 6_suppl ( 2020-02-20), p. 585-585
Abstract:
585 Background: This study aims to compare oncologic outcomes among patients who underwent salvage radical cystectomy (sRC) for recurrent urothelial carcinoma (UC) of the bladder following radiotherapy (RT) with primary radical cystectomy (pRC). Methods: We retrospectively reviewed the data of 3705 primary consented cystectomy patients of our IRB-approved bladder cancer database from Jan 1971 to June 2017 who underwent radical cystectomy for urothelial carcinoma of the bladder. Clinical and pathological data at the time of both RT and RC was collected. Patients with non-UCs and those receiving radiation for non-UCs were excluded. Multivariate analyses was performed to identify prognostic factors after RC for overall survival and recurrence-free survival. Results: 3050 patients were identified who underwent radical cystectomy for UC of the bladder. Of these, 128 patients (4.2%) underwent sRC following radiotherapy (RT). Patient characteristics including age, BMI, gender, and comorbidities were similar between the groups. Complications rates between the groups were similar at 30 days (43% sRC vs 39% pRC patients, p=0.41) and 90 days (52% sRC vs 48% pRC, p=0.42). Patients receiving sRC were less likely to receive a continent diversion (p 〈 0.001). Five-year overall survival following sRC was 47% in comparison to 63% for those undergoing pRC (p 〈 0.001) (Fig 1). However, no significant difference in five-year recurrence free survival was found (61% sRC vs 68% pRC; p=0.15). On multivariate analysis, sRC (HR 1.37, p=0.048), pathologic tumor stage ≥pT3a (HR 2.6, P 〈 0.001) and lymph node metastases (HR 2.5, P 〈 0.001) were associated with increased risk of local recurrence after radical cystectomy. Conclusions: Patients undergoing sRC are less likely to receive a continent urinary diversion and are at increased risk of local recurrence following cystectomy in comparison to patients receiving primary cystectomy.
Type of Medium:
Online Resource
ISSN:
0732-183X
,
1527-7755
DOI:
10.1200/JCO.2020.38.6_suppl.585
Language:
English
Publisher:
American Society of Clinical Oncology (ASCO)
Publication Date:
2020
detail.hit.zdb_id:
2005181-5
