Mattia Longoni, Andrea Marmiroli, Fabian Falkenbach, Quynh Chi Le, Michele Nicolazzini, Calogero Catanzaro, Federico Polverino, Jordan A Goyal, Matteo Ferro, Markus Graefen, Felix K H Chun, Carlotta Palumbo, Riccardo Schiavina, Nicola Longo, Fred Saad, Shahrokh F Shariat, Marco Moschini, Giorgio Gandaglia, Francesco Montorsi, Alberto Briganti, Pierre I Karakiewicz
{"title":"Cancer-Specific Survival of Trimodal Therapy Versus Radical Cystectomy in T2N0M0 Non-Urothelial Bladder Cancer.","authors":"Mattia Longoni, Andrea Marmiroli, Fabian Falkenbach, Quynh Chi Le, Michele Nicolazzini, Calogero Catanzaro, Federico Polverino, Jordan A Goyal, Matteo Ferro, Markus Graefen, Felix K H Chun, Carlotta Palumbo, Riccardo Schiavina, Nicola Longo, Fred Saad, Shahrokh F Shariat, Marco Moschini, Giorgio Gandaglia, Francesco Montorsi, Alberto Briganti, Pierre I Karakiewicz","doi":"10.1002/jso.70014","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>We hypothesized that, within organ-confined (OC, T2N0M0) non-urothelial carcinoma of urinary bladder (non-UCUB) patients, trimodal therapy (TMT) use does not differ from radical cystectomy (RC) regarding cancer control outcomes.</p><p><strong>Methods: </strong>Within the SEER database (2004-2021), rates of TMT versus RC use in OC non-UCUB patients were calculated. Nearest-neighbor 1:1 propensity score matching (PSM) for age, sex, race/ethnicity, and histological subtype was applied. Cumulative incidence plots depicted 5-year cancer-specific (CSM) and other-cause mortality (OCM) rates. Multivariable competing risks regression (CRR) models were fitted. Sensitivity analyses were performed within squamous cell (SCC), neuroendocrine (NEC), and adenocarcinoma (ADK) and other histological subtypes.</p><p><strong>Results: </strong>Of 814 OC non-UCUB patients, 310 (38%) received TMT versus 504 (62%) RC. After PSM, 5-year CSM rate was 50% after TMT versus 29% after RC and TMT was associated with 2.1-fold higher CSM relative to RC (multivariable HR [mHR]: 2.1, p < 0.001). In sensitivity analyses within 229 (28%) SCC, TMT patients had higher 5-year CSM rates relative to their RC-counterparts (67% vs. 22%, mHR: 4.3, p < 0.001). Similarly, within 314 (39%) NEC, TMT patients had higher 5-year CSM rates relative to their RC-counterparts (mHR: 1.8, p < 0.001). Conversely, within 118 (28%) ADK and 153 (19%) other subtypes, CSM after TMT did not differ from CSM after RC (33% vs. 15%, mHR: 1.4 and 43% vs. 33%, mHR: 1.4; p = 0.4).</p><p><strong>Conclusion: </strong>In OC non-UCUB patients TMT is associated with significantly higher CSM than RC. Most pronounced survival disadvantage was recorded within SCC and NEC patients.</p>","PeriodicalId":17111,"journal":{"name":"Journal of Surgical Oncology","volume":" ","pages":""},"PeriodicalIF":2.0000,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Surgical Oncology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1002/jso.70014","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"ONCOLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Introduction: We hypothesized that, within organ-confined (OC, T2N0M0) non-urothelial carcinoma of urinary bladder (non-UCUB) patients, trimodal therapy (TMT) use does not differ from radical cystectomy (RC) regarding cancer control outcomes.
Methods: Within the SEER database (2004-2021), rates of TMT versus RC use in OC non-UCUB patients were calculated. Nearest-neighbor 1:1 propensity score matching (PSM) for age, sex, race/ethnicity, and histological subtype was applied. Cumulative incidence plots depicted 5-year cancer-specific (CSM) and other-cause mortality (OCM) rates. Multivariable competing risks regression (CRR) models were fitted. Sensitivity analyses were performed within squamous cell (SCC), neuroendocrine (NEC), and adenocarcinoma (ADK) and other histological subtypes.
Results: Of 814 OC non-UCUB patients, 310 (38%) received TMT versus 504 (62%) RC. After PSM, 5-year CSM rate was 50% after TMT versus 29% after RC and TMT was associated with 2.1-fold higher CSM relative to RC (multivariable HR [mHR]: 2.1, p < 0.001). In sensitivity analyses within 229 (28%) SCC, TMT patients had higher 5-year CSM rates relative to their RC-counterparts (67% vs. 22%, mHR: 4.3, p < 0.001). Similarly, within 314 (39%) NEC, TMT patients had higher 5-year CSM rates relative to their RC-counterparts (mHR: 1.8, p < 0.001). Conversely, within 118 (28%) ADK and 153 (19%) other subtypes, CSM after TMT did not differ from CSM after RC (33% vs. 15%, mHR: 1.4 and 43% vs. 33%, mHR: 1.4; p = 0.4).
Conclusion: In OC non-UCUB patients TMT is associated with significantly higher CSM than RC. Most pronounced survival disadvantage was recorded within SCC and NEC patients.
期刊介绍：
The Journal of Surgical Oncology offers peer-reviewed, original papers in the field of surgical oncology and broadly related surgical sciences, including reports on experimental and laboratory studies. As an international journal, the editors encourage participation from leading surgeons around the world. The JSO is the representative journal for the World Federation of Surgical Oncology Societies. Publishing 16 issues in 2 volumes each year, the journal accepts Research Articles, in-depth Reviews of timely interest, Letters to the Editor, and invited Editorials. Guest Editors from the JSO Editorial Board oversee multiple special Seminars issues each year. These Seminars include multifaceted Reviews on a particular topic or current issue in surgical oncology, which are invited from experts in the field.
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