Vallo, Stefan and Gilfrich, Christian and Burger, Maximilian and Volkmer, Bjoern and Boehm, Katharina and Rink, Michael and Chun, Felix K. and Roghmann, Florian and Novotny, Vladimir and Mani, Jens and Brisuda, Antonin and Mayr, Roman and Stredele, Regina and Noldus, Joachim and Schnabel, Marco and May, Matthias and Fritsche, Hans-Martin and Pycha, Armin and Martini, Thomas and Wirth, Manfred and Roigas, Jan and Bastian, Patrick J. and Nuhn, Philipp and Dahlem, Roland and Haferkamp, Axel and Fisch, Margit and Aziz, Atiqullah (2016) Comparative analysis of the effect of prostatic invasion patterns on cancer-specific mortality after radical cystectomy in pT4a urothelial carcinoma of the bladder. UROLOGIC ONCOLOGY-SEMINARS AND ORIGINAL INVESTIGATIONS, 34 (10). ISSN 1078-1439, 1873-2496
Full text not available from this repository. (Request a copy)Abstract
Purpose: To evaluate the prognostic relevance of different prostatic invasion patterns in pT4a urothelial carcinoma of the bladder (UCB) after radical cystectomy. Materials and methods: Our study comprised a total of 358 men with pT4a UCB. Patients were divided in 2 groups-group A with stromal infiltration of the prostate via the prostatic urethra with additional muscle-invasive UCB (n = 121, 33.8%) and group B with continuous infiltration of the prostate through the entire bladder wall (n = 237, 66.2%). The effect of age, tumor grade, carcinoma in situ, lymphovascular invasion, soft tissue surgical margin, lymph node metastases, administration of adjuvant chemotherapy, and prostatic invasion patterns on cancer-specific mortality (CSM) was evaluated using competing-risk regression analysis. Decision curve analysis was used to evaluate the net benefit of including the variable invasion pattern within our model. Results: The estimated 5-year CSM-rates for group A and B were 50.1% and 66.0%, respectively. In multivariable competing-risk analysis, lymph node metastases (hazard ratio [HR] = 1.73, P < 0.001), lymphovascular invasion (HR = 1.62, P = 0.0023), soft tissue surgical margin (HR = 1.49, P = 0.026), absence of adjuvant chemotherapy (HR = 2.11, P < 0.001), and tumor infiltration of the prostate by continuous infiltration of the entire bladder wall (HR = 1.37, P = 0.044) were significantly associated with a higher risk for CSM. Decision curve analysis showed a net benefit of our model including the variable invasion pattern. Conclusions: Continuous infiltration of the prostate through the entire bladder wall showed an adverse effect on CSM. Besides including these patients into clinical trials for an adjuvant therapy, we recommend including prostatic invasion patterns in predictive models in pT4a UCB in men.Copyright (C) 2016 Elsevier Inc. All rights reserved.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | TRANSITIONAL-CELL CARCINOMA; STROMAL INVASION; EAU GUIDELINES; NEOADJUVANT CHEMOTHERAPY; SURVIVAL-DATA; TUMOR STAGE; INVOLVEMENT; INFILTRATION; RECURRENCE; OUTCOMES; Bladder cancer; Radical cystectomy; Mortality; Outcome; Prostatic invasion pattern |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Urologie |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 12 Apr 2019 13:08 |
| Last Modified: | 12 Apr 2019 13:08 |
| URI: | https://pred.uni-regensburg.de/id/eprint/4124 |
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