Abstract
Background: Muscle-invasive bladder cancer (MIBC) may be managed with radical cystectomy (RC) or chemoradiotherapy (CRT). Because patient selection for RC is important to avoid treatment-related mortality, this study addressed a knowledge gap by quantifying short-term mortality with both approaches, as well as predictors thereof. Materials and Methods: The National Cancer Database was queried (2004-2014) for clinically staged T2-4aN0M0 MIBC that received either CRT or RC. Statistics included cumulative incidence comparisons of 30- and 90-day mortality between patients treated with either CRT or RC and Cox regression to evaluate predictors thereof. Results: Of 16,658 patients, 15,208 (91.3%) underwent RC and 1450 (8.7%) CRT. Crude rates of post-treatment mortality at 30 days were 2.7% versus 0.6% (P <. 001) and at 90 days were 7.5% versus 4.5% (P =. 017) for patients treated with RC and CRT, respectively. When stratifying by age, worse 30- and 90-day mortality with RC was observed for patients aged ≥ 76 years. Conclusions: This study describes 30- and 90-day mortality following RC versus CRT. Both approaches yield statistically similar treatment-related mortality rates in patients ≤ 75 years of age; however, worse post-treatment mortality was observed with use of RC in patients ≥ 76 years of age. These results may be utilized to better inform shared decision-making between patients and providers when weighing both RC and CRT for MIBC.
Original language | English (US) |
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Pages (from-to) | e1069-e1079 |
Journal | Clinical Genitourinary Cancer |
Volume | 17 |
Issue number | 5 |
DOIs | |
State | Published - Oct 2019 |
Keywords
- Bladder cancer
- Chemoradiation
- Cystectomy
- Geriatric oncology
- Organ preservation therapy
ASJC Scopus subject areas
- Oncology
- Urology