To assess whether progressive and primary muscle invasive bladder cancer (MIBC) have different prognosis after radical cystectomy or not. To date only a few data are available on this topic with conflicting results. Further studies on large cohort are needed to clarify these outcomes that may influence bladder cancer management for these patients.
A multicentre retrospective study was conducted on patient treated for MIBC at 5 centres between 2005 and 2015 by radical cystectomy. Patients' outcomes were compared between patients with primary MIBC vs. progressive MIBC subsequent to a history of non-muscle invasive bladder cancer (NMIBC).
A total of 1197 patients were included. Median (IQ) age was 65 (58-72) years and median follow-up was 65 months. Baseline characteristics were similar between the groups as well as the Tumour pT stage, N status and positive surgical margins. Patients with progressive MIBC had worse overall survival (OS) (hazard ratio [HR] 1.36, [95%CI 1.10-1.76]; P = 0.004), cancer specific survival (CSS) (HR 1.41 [1.13-1.78]; P = 0.002), and recurrence-free survival (RFS) (HR 1.21 [1.01-1.49]; P = 0.05). Pathological stage ≥pT3, positive surgical margins, and positive lymph nodes status (pN+) were also found as predictors of OS, CSS, and RFS.
Our results suggest that patient having a progressive BC have a worse prognosis in terms of OS, PFS, and CSS than patient with primary disease. These 2 groups may require different management and patients with high risk NMIBC should be assessed properly to avoid progression and be offered early cystectomy.
Urologic oncology. 2020 Nov 16 [Epub ahead of print]
François-Xavier Nouhaud, Marouene Chakroun, Claire Lenormand, Idir Ouzaid, Benoit Peyronnet, Alexandre Gryn, Thomas Prudhomme, Vivien Grafeille, Michel Soulié, Mathieu Roumiguié, Grégory Verhoest, Evanguelos Xylinas, Abderrazak Bouzouita, Mohamed Chebil, Christian Pfister
Department of Urology, Rouen University Hospital, Rouen, France. Electronic address: ., Department of Urology, Tunis University Hospital, Tunis, Tunisia., Department of Urology, Rouen University Hospital, Rouen, France., Department of Urology, Bichat University Hospital, Paris, France., Department of Urology, Rennes University Hospital, Rennes, France., Department, of Urology, Toulouse University Hospital, Toulouse, France.