Treatment Patterns and Radical Cystectomy Outcomes in Patients Diagnosed With Urothelial Nonmetastatic Muscle‐Invasive Bladder Cancer in the United States

ABSTRACT Purpose To characterize trends and patterns in treatment characteristics and perioperative outcomes of patients with urothelial muscle‐invasive bladder cancer (MIBC). Materials and Methods We utilized the National Cancer Database to assess trends and patterns in treatment modalities (radica...

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Published in:Cancer medicine (Malden, MA) Vol. 14; no. 4; pp. e70644 - n/a
Main Authors: Davies‐Teye, Bernard Bright, Siddiqui, M. Minhaj, Zhang, Xiao, Johnson, Abree, Burcu, Mehmet, Onukwugha, Eberechukwu, Hanna, Nader
Format: Journal Article
Language:English
Published: United States John Wiley & Sons, Inc 01.02.2025
John Wiley and Sons Inc
Wiley
Subjects:
Aged
Aged, 80 and over
Bladder cancer
Cancer
Cancer therapies
Chemotherapy
Chemotherapy, Adjuvant
Chi-square test
Combined Modality Therapy
Comorbidity
conservative treatment
Cystectomy - methods
Cystectomy - trends
cystectomy radical
Female
Histology
Humans
Invasiveness
Male
Middle Aged
Mortality
neoadjuvant chemotherapy
Neoadjuvant Therapy
Neoplasm Invasiveness
Patients
Practice Patterns, Physicians' - trends
Quality of life
Radiation therapy
Surgery
Surgical outcomes
Survival analysis
Treatment Outcome
treatment outcomes
Trends
Tumors
United States - epidemiology
urinary bladder neoplasm
Urinary Bladder Neoplasms - mortality
Urinary Bladder Neoplasms - pathology
Urinary Bladder Neoplasms - surgery
Urinary Bladder Neoplasms - therapy
Urological surgery
Urothelial cancer
Variables
United States
United States > US
neoadjuvant chemotherapy
urinary bladder neoplasm
cystectomy radical
conservative treatment
treatment outcomes
ISSN:2045-7634, 2045-7634
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Summary:ABSTRACT Purpose To characterize trends and patterns in treatment characteristics and perioperative outcomes of patients with urothelial muscle‐invasive bladder cancer (MIBC). Materials and Methods We utilized the National Cancer Database to assess trends and patterns in treatment modalities (radical cystectomy [RC] with or without neoadjuvant/adjuvant treatments, trimodal bladder‐sparing treatment [trimodal treatment], and others) among MIBC patients diagnosed between 2004 and 2017. We also assessed trends and patterns of short‐term post‐surgery outcomes, including 30‐day and 90‐day mortality, and readmissions. Results Among 83,259 MIBC patients, those who received RC, trimodal treatment, and transurethral resection of bladder tumor (TURBT) plus chemotherapy were 34,715 (41.7%), 7,372 (8.9%), and 6,171 (7.4%), respectively. A substantial proportion (29,314; 35.2%) of MIBC patients received other treatments, including TURBT‐only. From 2004 through 2017, the proportion of MIBC patients who utilized guideline‐recommended treatments, whether RC (from 36.4% to 42.8%) or trimodal treatment (from 7.9% to 10.2%), increased. Among those who received RC, there was a substantial increase in neoadjuvant chemotherapy (NAC) utilization, from 7.8% to 29.4%. Conversely, utilization of RC without perioperative treatments decreased from 62.3% to 32.7%. There was a significant decrease in 30‐day (2.8%–1.8%) and 90‐day (7.1%–5.3%) mortality rates among RC recipients. Conclusion There was a shift in treatment modalities for MIBC, with increased utilization of RC with NAC. A decrease in post‐surgery mortality rates may indicate improved outcomes, although the unmet need for NAC utilization requires further investigation. Precise This study characterized trends and patterns in treatment characteristics and perioperative outcomes of patients with urothelial muscle‐invasive bladder cancer (MIBC). We utilized the National Cancer Database to assess trends and patterns in treatment modalities (radical cystectomy [RC] with or without neoadjuvant/adjuvant treatments, trimodal bladder‐sparing treatment [trimodal treatment], and others) among MIBC patients diagnosed between 2004 and 2017. There was a shift in treatment modalities for MIBC, with increased utilization of RC with NAC. A decrease in post‐surgery mortality rates may indicate improved outcomes, although the unmet need for NAC utilization requires further investigation.
Bibliography:This study was funded by Merck Sharp and Dohme LLC, a subsidiary of Merck and Co., Inc., Rahway, NJ, United States. Co‐authors, from Merck Sharp and Dohme LLC, a subsidiary of Merck & Co., Inc., Rahway, NJ, USA, contributed to the conception, design, planning, interpretation of results, and critical review of the manuscript for intellectual content.
Funding
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Funding: This study was funded by Merck Sharp and Dohme LLC, a subsidiary of Merck and Co., Inc., Rahway, NJ, United States. Co‐authors, from Merck Sharp and Dohme LLC, a subsidiary of Merck & Co., Inc., Rahway, NJ, USA, contributed to the conception, design, planning, interpretation of results, and critical review of the manuscript for intellectual content.
ISSN:2045-7634
2045-7634
DOI:10.1002/cam4.70644