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 |
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John Wiley & Sons, Inc
01.02.2025
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| Abstract | 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. |
|---|---|
| AbstractList | 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. 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. 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. To characterize 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. We also assessed trends and patterns of short-term post-surgery outcomes, including 30-day and 90-day mortality, and readmissions. 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. 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. To characterize trends and patterns in treatment characteristics and perioperative outcomes of patients with urothelial muscle-invasive bladder cancer (MIBC).PURPOSETo characterize 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. We also assessed trends and patterns of short-term post-surgery outcomes, including 30-day and 90-day mortality, and readmissions.MATERIALS AND METHODSWe 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.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.RESULTSAmong 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.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.CONCLUSIONThere 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. |
| Author | Zhang, Xiao Johnson, Abree Davies‐Teye, Bernard Bright Onukwugha, Eberechukwu Siddiqui, M. Minhaj Burcu, Mehmet Hanna, Nader |
| AuthorAffiliation | 2 University of Maryland School of Medicine Baltimore Maryland USA 3 Merck & Co., Inc. Rahway New Jersey USA 1 Department of Practice, Sciences, and Health Outcomes Research University of Maryland School of Pharmacy Baltimore Maryland USA |
| AuthorAffiliation_xml | – name: 1 Department of Practice, Sciences, and Health Outcomes Research University of Maryland School of Pharmacy Baltimore Maryland USA – name: 3 Merck & Co., Inc. Rahway New Jersey USA – name: 2 University of Maryland School of Medicine Baltimore Maryland USA |
| Author_xml | – sequence: 1 givenname: Bernard Bright orcidid: 0000-0001-8653-9338 surname: Davies‐Teye fullname: Davies‐Teye, Bernard Bright email: bbdavies‐teye@umaryland.edu organization: University of Maryland School of Pharmacy – sequence: 2 givenname: M. Minhaj surname: Siddiqui fullname: Siddiqui, M. Minhaj organization: University of Maryland School of Medicine – sequence: 3 givenname: Xiao surname: Zhang fullname: Zhang, Xiao organization: Merck & Co., Inc – sequence: 4 givenname: Abree surname: Johnson fullname: Johnson, Abree organization: University of Maryland School of Pharmacy – sequence: 5 givenname: Mehmet surname: Burcu fullname: Burcu, Mehmet organization: Merck & Co., Inc – sequence: 6 givenname: Eberechukwu orcidid: 0000-0001-8547-1810 surname: Onukwugha fullname: Onukwugha, Eberechukwu organization: University of Maryland School of Pharmacy – sequence: 7 givenname: Nader surname: Hanna fullname: Hanna, Nader organization: University of Maryland School of Medicine |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/39945337$$D View this record in MEDLINE/PubMed |
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| ContentType | Journal Article |
| Copyright | 2025 The Author(s). published by John Wiley & Sons Ltd. 2025 The Author(s). Cancer Medicine published by John Wiley & Sons Ltd. 2025. This work is published under http://creativecommons.org/licenses/by/4.0/ (the "License"). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License. |
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| Keywords | neoadjuvant chemotherapy urinary bladder neoplasm cystectomy radical conservative treatment treatment outcomes |
| Language | English |
| License | Attribution 2025 The Author(s). Cancer Medicine published by John Wiley & Sons Ltd. This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. |
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| Notes | 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 ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 14 content type line 23 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. |
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Purpose
To characterize trends and patterns in treatment characteristics and perioperative outcomes of patients with urothelial muscle‐invasive... This study characterized trends and patterns in treatment characteristics and perioperative outcomes of patients with urothelial muscle‐invasive bladder cancer... To characterize trends and patterns in treatment characteristics and perioperative outcomes of patients with urothelial muscle-invasive bladder cancer (MIBC).... ABSTRACT Purpose To characterize trends and patterns in treatment characteristics and perioperative outcomes of patients with urothelial muscle‐invasive... To characterize trends and patterns in treatment characteristics and perioperative outcomes of patients with urothelial muscle-invasive bladder cancer... |
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| SubjectTerms | 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 |
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| Title | Treatment Patterns and Radical Cystectomy Outcomes in Patients Diagnosed With Urothelial Nonmetastatic Muscle‐Invasive Bladder Cancer in the United States |
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