How cancer-specific mortality changes over time after radical cystectomy: Conditional survival of patients with nonmetastatic urothelial carcinoma of the urinary bladder
How cancer-specific mortality changes over time after radical cystectomy: Conditional survival of patients with nonmetastatic urothelial carcinoma of the urinary bladder
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DOI：
10.1016/j.urolonc.2019.05.020
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发表时间：
2019-12-01
影响因子：
2.7
通讯作者：
Karakiewicz, Pierre I.
中科院分区：
文献类型：
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作者：
Palumbo, Carlotta;Mistretta, Francesco A.;Karakiewicz, Pierre I.
目的：我们研究了条件生存对5年癌症特异性死亡率（CSM）概率的影响，在当代北美人群为基础的非转移性膀胱尿路上皮癌队列接受根治性化疗。方法和材料：在SEER数据库中（2004-2015），我们确定了pTa/pTis/pT 1 N 0高级别、pT 2至pT 4 N 0和pTanyN 1 -3患者接受根治性环磷酰胺治疗非转移性膀胱尿路上皮癌。在无事件随访持续时间后评估了条件性5年无CSM估计值。多变量考克斯回归模型根据无事件随访时间预测CSM。结果：根据T和N分期，包括1，079（7.9%）pTa/pTis/pT 1 N 0，5，058（37.2%）pT 2N 0，2，865（21.1%）pT 3 N 0，1，211（8.9%）pT 4 N 0和3，382（24.9%）pTanyN 1 -3患者。5年无事件随访后，pTa/pTis/pT 1 N 0、pT 2N 0、pT 3 N 0、pT 4 N 0和pTanyN 1 -3患者的条件性无CSM估计值分别从90.1%增加至91.8%、80.6%增加至92.5%、62.5%增加至90.7%、53.1%增加至84.5%和37.5%增加至84.0%。pTanyN 1 -3队列中死亡率引起的死亡率最高，pTa/pTis/pT 1 N 0队列中最低。在多变量考克斯回归分析中，pT 2 N 0（风险比[HR] 1.9 P
Objectives: We studied the effect of conditional survival on 5-year cancer-specific mortality (CSM) probability in a contemporary North-American population-based nonmetastatic urothelial carcinoma of urinary bladder cohort treated with radical cystectomy.Methods and materials: Within the SEER database (2004-2015), we identified pTa/pTis/pT1N0 high grade, pT2 to pT4N0 and pTanyN1-3 patients treated with radical cystectomy for nonmetastatic urothelial carcinoma of urinary bladder. Conditional 5-year CSM-free estimates were assessed after event-free follow-up duration. Multivariable Cox regression models predicted CSM according to event-free follow-up duration.Results: According to T and N stages, 1,079 (7.9%) pTa/pTis/pT1N0, 5,058 (37.2%) pT2N0, 2,865 (21.1%) pT3N0, 1,211 pT4N0 (8.9%) and 3,382 (24.9%) pTanyN1-3 patients were included. Conditional CSM-free estimates increased from 90.1 to 91.8%, 80.6 to 92.5%, 62.5 to 90.7%, 53.1 to 84.5%, and 37.5 to 84.0% after 5 years of event-free follow-up, in respectively pTa/pTis/pT1N0, pT2N0, pT3N0, pT4N0, and pTanyN1-3 patients. Attrition due to mortality was highest in pTanyN1-3 cohort and lowest in pTa/pTis/pT1N0. In Multivariable Cox regression analyses, pT2N0 (hazard ratio [HR] 1.9 P