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Characterization of Late Recurrence After Radical Cystectomy in a Large Multicenter Cohort of Bladder Cancer Patients.

Abstract：

OBJECTIVE:To investigate the characteristics and outcomes of late recurrence (LR) in patients with bladder cancer (BCa) treated with radical cystectomy (RC) and to identify clinicopathologic predictors of LR and postrecurrence survival. MATERIALS AND METHODS:This multicenter study included 1652 BCa patients. LR was defined as occurring more than 5 years after RC. Differences in postrecurrence overall survival according to the timing of disease recurrence and the location of recurrence were calculated using the log-rank test. A logistic regression model was used to identify predictors of LR, and Cox regression models were used to evaluate variables associated with postrecurrence overall survival (OS). RESULTS:Overall, 548 patients experienced disease recurrence. Of these, 67 patients (12.2%) experienced LR, with a median time to recurrence of 86 months (interquartile range 70.5-107.2). LR was more likely to be located in the urothelium (P = .005). On multivariable analysis, younger age (P = .008) and non-organ confined disease (P = .03) were found to be predictors of LR. Postrecurrence 5-year OS was worse in patients who experienced early recurrence compared with those with LR (12% vs 25%, P = .02) and in those with nonurothelial recurrence compared to those with disease recurrence in the remaining urothelium (12% vs 51%, P < .001). Older age (P < .001), non-organ confined disease at RC (P = .02), and nonurothelial recurrence site (P = .002) were independently associated with postrecurrence OS. CONCLUSION:LR after RC is an uncommon but non-negligible event that harbors unique characteristics. LR is associated with better OS compared to early recurrence. Our findings reinforce the need for lifelong follow-up of BCa patients after RC.

journal_name

Urology

journal_title

Urology

authors

Soria F,Moschini M,Wirth GJ,Gust KM,Klatte T,Briganti A,Gontero P,Abufaraj M,Özsoy M,Karakiewicz PI,Shariat SF

doi

10.1016/j.urology.2017.04.049

subject

Has Abstract

pub_date

2017-08-01 00:00:00

pages

119-124

eissn

0090-4295

issn

1527-9995

pii

S0090-4295(17)30487-9

journal_volume

106

pub_type

杂志文章,多中心研究

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