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Thomas Flaig, MD


ASTRO 2022: Radiotherapy Versus Surgery for Node-Positive, Nonmetastatic Bladder Cancer

By: Celeste L. Dixon
Posted: Wednesday, October 26, 2022

After chemotherapy, radical-intent treatment versus palliative treatment results in longer overall survival for many individuals with clinically node-positive, nonmetastatic bladder cancer (cN+M0). However, given that the results of a large retrospective analysis revealed that both types of radical-intent treatment—radical cystectomy and bladder-preserving radical radiotherapy—result in equivalent survival outcomes, the “data would support wider use of radiotherapy to avoid risks from major surgery in node-positive patients,” according to Martin Swinton, MBBChir, of Christie Hospital, Manchester, United Kingdom, and colleagues. These study findings were presented during the 2022 American Society for Radiation Oncology (ASTRO) Annual Meeting (Abstract 236).

Included in this study were 288 patients treated at four United Kingdom medical centers between 2012 and 2021, who had a median overall survival of 1.5 years. For the 163 patients treated with radical intent (cystectomy, 76; radiotherapy, 87), that figure was 2.4 years, with no significant difference between the two subgroups (2.1 vs. 2.5 years, respectively; P = .5). The difference between 2.4 years and the 0.9-year overall survival in the 125 patients who received palliative treatment was significant (P < .0001).

According to the study authors, no variables in patients who received radical treatment were significant for improved overall survival in multivariable analysis. However, in univariable analysis, the researchers stated, improved overall survival was positively associated with a lower performance status (P = .02), lower tumor stage (P = .03), and receipt of primary chemotherapy (P = .01).

“This multicenter retrospective analysis of survival outcomes gives real-world data on a large cohort of patients with cN+M0 bladder cancer,” the investigators noted.

Disclosure: Dr. Swinton reported no financial conflicts of interest.

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