Predicting the survival of bladder carcinoma patients treated with radical cystectomy

Liang Cheng, Amy L. Weaver, Bradley C. Leibovich, Dharamdas M. Ramnani, Roxann M. Neumann, Beth G. Scherer, Ajay Nehra, Horst Zincke, David G. Bostwick

Research output: Contribution to journalArticle

112 Citations (Scopus)

Abstract

BACKGROUND. Clinical outcomes vary for patients treated with radical cystectomy. The authors sought to identify factors associated with the survival of patients treated with radical cystectomy for urothelial carcinoma of the urinary, bladder. METHODS. The authors studied 218 patients treated with radical cystectomy for urothelial carcinoma between 1980 to 1984. Patient ages ranged from 41 to 78 years (mean, 64 years). Using the 1997 TNM system, T classifications were Ta (17 patients), T1 (44), T2 (71), T3a (42), T3b (14), T4a (28), and T4b (2). Thirty-two patients had lymph node metastasis at the time of surgery. Histologic grade was determined according to the newly proposed World Health Organization and International Society of Urological Pathology grading system; tumor was low grade in 43 patients and high grade in 175. The male-to-female ratio was 4.9 to 1. The mean follow-up of patients still alive was 13.1 years (median, 13.8 years; range, 30 days to 18 years). Cox proportional hazards models were used to determine the impact of numerous clinical and pathologic findings on survival. RESULTS. Ten-year local recurrence free, distant metastasis free, cancer specific, and all- cause survival were 71%, 73%, 67%, and 41%, respectively. In univariate analysis, cancer size, T classification, and lymph node status were associated with distant metastasis free, cancer specific, and all-cause survival. Histologic grade and surgical margin status were significantly associated with worse cancer specific and all-cause survival, but not with distant metastasis free survival. In multivariate analysis, cancer size, margin status, T classification, and lymph node status were identified as significantly associated with cancer specific survival after adjustment for age and gender. CONCLUSIONS. Long term survival is achieved in a significant number of patients treated with radical cystectomy. In this study, patients with organ-confined (≤ pT2) and small size (≤ 3 cm) cancer had favorable 10-year distant metastasis free (93%) and cancer specific survival (88%) after cystectomy. Tumor size, margin status, extravesical involvement, and lymph node metastasis are important pathologic factors and should be considered as stratification variables in identifying patients for whom adjuvant chemotherapy should be evaluated in clinical trials. (C) 2000 American Cancer Society.

Original languageEnglish (US)
Pages (from-to)2326-2332
Number of pages7
JournalCancer
Volume88
Issue number10
DOIs
StatePublished - May 15 2000

Fingerprint

Cystectomy
Urinary Bladder
Carcinoma
Survival
Neoplasms
Neoplasm Metastasis
Lymph Nodes
Adjuvant Chemotherapy
Proportional Hazards Models
Multivariate Analysis
Clinical Trials
Pathology
Recurrence

Keywords

  • Bladder neoplasms
  • Cancer size
  • Cystectomy
  • Margin
  • Metastasis
  • Progression
  • Recurrence
  • Staging
  • Survival

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

Cheng, L., Weaver, A. L., Leibovich, B. C., Ramnani, D. M., Neumann, R. M., Scherer, B. G., ... Bostwick, D. G. (2000). Predicting the survival of bladder carcinoma patients treated with radical cystectomy. Cancer, 88(10), 2326-2332. https://doi.org/10.1002/(SICI)1097-0142(20000515)88:10<2326::AID-CNCR17>3.0.CO;2-T

Predicting the survival of bladder carcinoma patients treated with radical cystectomy. / Cheng, Liang; Weaver, Amy L.; Leibovich, Bradley C.; Ramnani, Dharamdas M.; Neumann, Roxann M.; Scherer, Beth G.; Nehra, Ajay; Zincke, Horst; Bostwick, David G.

In: Cancer, Vol. 88, No. 10, 15.05.2000, p. 2326-2332.

Research output: Contribution to journalArticle

Cheng, L, Weaver, AL, Leibovich, BC, Ramnani, DM, Neumann, RM, Scherer, BG, Nehra, A, Zincke, H & Bostwick, DG 2000, 'Predicting the survival of bladder carcinoma patients treated with radical cystectomy', Cancer, vol. 88, no. 10, pp. 2326-2332. https://doi.org/10.1002/(SICI)1097-0142(20000515)88:10<2326::AID-CNCR17>3.0.CO;2-T
Cheng, Liang ; Weaver, Amy L. ; Leibovich, Bradley C. ; Ramnani, Dharamdas M. ; Neumann, Roxann M. ; Scherer, Beth G. ; Nehra, Ajay ; Zincke, Horst ; Bostwick, David G. / Predicting the survival of bladder carcinoma patients treated with radical cystectomy. In: Cancer. 2000 ; Vol. 88, No. 10. pp. 2326-2332.
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abstract = "BACKGROUND. Clinical outcomes vary for patients treated with radical cystectomy. The authors sought to identify factors associated with the survival of patients treated with radical cystectomy for urothelial carcinoma of the urinary, bladder. METHODS. The authors studied 218 patients treated with radical cystectomy for urothelial carcinoma between 1980 to 1984. Patient ages ranged from 41 to 78 years (mean, 64 years). Using the 1997 TNM system, T classifications were Ta (17 patients), T1 (44), T2 (71), T3a (42), T3b (14), T4a (28), and T4b (2). Thirty-two patients had lymph node metastasis at the time of surgery. Histologic grade was determined according to the newly proposed World Health Organization and International Society of Urological Pathology grading system; tumor was low grade in 43 patients and high grade in 175. The male-to-female ratio was 4.9 to 1. The mean follow-up of patients still alive was 13.1 years (median, 13.8 years; range, 30 days to 18 years). Cox proportional hazards models were used to determine the impact of numerous clinical and pathologic findings on survival. RESULTS. Ten-year local recurrence free, distant metastasis free, cancer specific, and all- cause survival were 71{\%}, 73{\%}, 67{\%}, and 41{\%}, respectively. In univariate analysis, cancer size, T classification, and lymph node status were associated with distant metastasis free, cancer specific, and all-cause survival. Histologic grade and surgical margin status were significantly associated with worse cancer specific and all-cause survival, but not with distant metastasis free survival. In multivariate analysis, cancer size, margin status, T classification, and lymph node status were identified as significantly associated with cancer specific survival after adjustment for age and gender. CONCLUSIONS. Long term survival is achieved in a significant number of patients treated with radical cystectomy. In this study, patients with organ-confined (≤ pT2) and small size (≤ 3 cm) cancer had favorable 10-year distant metastasis free (93{\%}) and cancer specific survival (88{\%}) after cystectomy. Tumor size, margin status, extravesical involvement, and lymph node metastasis are important pathologic factors and should be considered as stratification variables in identifying patients for whom adjuvant chemotherapy should be evaluated in clinical trials. (C) 2000 American Cancer Society.",
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T1 - Predicting the survival of bladder carcinoma patients treated with radical cystectomy

AU - Cheng, Liang

AU - Weaver, Amy L.

AU - Leibovich, Bradley C.

AU - Ramnani, Dharamdas M.

AU - Neumann, Roxann M.

AU - Scherer, Beth G.

AU - Nehra, Ajay

AU - Zincke, Horst

AU - Bostwick, David G.

PY - 2000/5/15

Y1 - 2000/5/15

N2 - BACKGROUND. Clinical outcomes vary for patients treated with radical cystectomy. The authors sought to identify factors associated with the survival of patients treated with radical cystectomy for urothelial carcinoma of the urinary, bladder. METHODS. The authors studied 218 patients treated with radical cystectomy for urothelial carcinoma between 1980 to 1984. Patient ages ranged from 41 to 78 years (mean, 64 years). Using the 1997 TNM system, T classifications were Ta (17 patients), T1 (44), T2 (71), T3a (42), T3b (14), T4a (28), and T4b (2). Thirty-two patients had lymph node metastasis at the time of surgery. Histologic grade was determined according to the newly proposed World Health Organization and International Society of Urological Pathology grading system; tumor was low grade in 43 patients and high grade in 175. The male-to-female ratio was 4.9 to 1. The mean follow-up of patients still alive was 13.1 years (median, 13.8 years; range, 30 days to 18 years). Cox proportional hazards models were used to determine the impact of numerous clinical and pathologic findings on survival. RESULTS. Ten-year local recurrence free, distant metastasis free, cancer specific, and all- cause survival were 71%, 73%, 67%, and 41%, respectively. In univariate analysis, cancer size, T classification, and lymph node status were associated with distant metastasis free, cancer specific, and all-cause survival. Histologic grade and surgical margin status were significantly associated with worse cancer specific and all-cause survival, but not with distant metastasis free survival. In multivariate analysis, cancer size, margin status, T classification, and lymph node status were identified as significantly associated with cancer specific survival after adjustment for age and gender. CONCLUSIONS. Long term survival is achieved in a significant number of patients treated with radical cystectomy. In this study, patients with organ-confined (≤ pT2) and small size (≤ 3 cm) cancer had favorable 10-year distant metastasis free (93%) and cancer specific survival (88%) after cystectomy. Tumor size, margin status, extravesical involvement, and lymph node metastasis are important pathologic factors and should be considered as stratification variables in identifying patients for whom adjuvant chemotherapy should be evaluated in clinical trials. (C) 2000 American Cancer Society.

AB - BACKGROUND. Clinical outcomes vary for patients treated with radical cystectomy. The authors sought to identify factors associated with the survival of patients treated with radical cystectomy for urothelial carcinoma of the urinary, bladder. METHODS. The authors studied 218 patients treated with radical cystectomy for urothelial carcinoma between 1980 to 1984. Patient ages ranged from 41 to 78 years (mean, 64 years). Using the 1997 TNM system, T classifications were Ta (17 patients), T1 (44), T2 (71), T3a (42), T3b (14), T4a (28), and T4b (2). Thirty-two patients had lymph node metastasis at the time of surgery. Histologic grade was determined according to the newly proposed World Health Organization and International Society of Urological Pathology grading system; tumor was low grade in 43 patients and high grade in 175. The male-to-female ratio was 4.9 to 1. The mean follow-up of patients still alive was 13.1 years (median, 13.8 years; range, 30 days to 18 years). Cox proportional hazards models were used to determine the impact of numerous clinical and pathologic findings on survival. RESULTS. Ten-year local recurrence free, distant metastasis free, cancer specific, and all- cause survival were 71%, 73%, 67%, and 41%, respectively. In univariate analysis, cancer size, T classification, and lymph node status were associated with distant metastasis free, cancer specific, and all-cause survival. Histologic grade and surgical margin status were significantly associated with worse cancer specific and all-cause survival, but not with distant metastasis free survival. In multivariate analysis, cancer size, margin status, T classification, and lymph node status were identified as significantly associated with cancer specific survival after adjustment for age and gender. CONCLUSIONS. Long term survival is achieved in a significant number of patients treated with radical cystectomy. In this study, patients with organ-confined (≤ pT2) and small size (≤ 3 cm) cancer had favorable 10-year distant metastasis free (93%) and cancer specific survival (88%) after cystectomy. Tumor size, margin status, extravesical involvement, and lymph node metastasis are important pathologic factors and should be considered as stratification variables in identifying patients for whom adjuvant chemotherapy should be evaluated in clinical trials. (C) 2000 American Cancer Society.

KW - Bladder neoplasms

KW - Cancer size

KW - Cystectomy

KW - Margin

KW - Metastasis

KW - Progression

KW - Recurrence

KW - Staging

KW - Survival

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