Bladder cancer: cytoreductive surgery improves survival

  • Pollock G & et al.
  • Urology
  • 19 Jan 2021

  • curated by Deepa Koli
  • Univadis Clinical Summaries
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Takeaway

  • Patients with metastatic upper tract urothelial cancer (UTUC) who undergo cytoreductive surgery (CRS) after chemotherapy experience an OS benefit vs those without surgery.

Why this matters

  • Data are limited regarding management of patients with metastatic UTUC treated with chemotherapy.

Study design

  • Study of 1182 patients with metastatic UTUC from the National Cancer Database treated with chemotherapy with or without CRS, 2004-2016.
  • Funding: None disclosed.

Key results

  • 29.5% of patients underwent surgery.
  • Median follow-up was 64 months for the chemotherapy+CRS group vs 61.2 for the chemotherapy-alone group (P=.09).
  • Patients who received CRS experienced improved median OS vs those treated with chemotherapy alone:
    • 13.7 vs 10.8 months (P<.001>
  • CRS was associated with prolonged OS in:
    • Inverse probability of treatment weighting-adjusted analysis: HR, 0.63 (P<.001>
    • Propensity score-matched analysis: HR, 0.61 (P<.0001>

Limitations

  • Retrospective.