Washington, DC (UroToday.com) The optimal duration of surveillance for bladder cancer (BC) following radical cystectomy (RC) is unknown.
Stewart-Merrill and colleagues from Penn State Hershey identified 2438 patients who underwent RC for M0 BC between 1980 and 2007 and stratified patients by pathologic stage, relapse location, age, and Charlson comorbidity index (CCI). Risks of disease recurrence and non-BC death were estimated. Median follow-up for the cohort was 6 years and 713 patients (29%) developed recurrences. Large differences in optimal surveillance duration were appreciated across the various stratified groups. For example, among patients 60 years old or younger with pT2N0MX disease, the risk of non-BC related death exceeded the risk of abdominal recurrence at 7.5 years only if the CCI was 3 or greater. The authors concluded that an individualized approach to post-RC surveillance that bases duration of follow-up on the interplay between competing risk factors for recurrence and non-BC death should be employed. Such an approach eliminates over simplified stopping points, better predicts BC disease course as it interacts with a patient’s overall health, and may improve the balance between surveillance benefit and medical resource allocation.
Suzanne B. Stewart-Merrill, MD. from the Society of Urologic Oncology Meeting - December 2 - 4, 2015 – Washington, DC.