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Radical Cystectomy: Comparing Outcomes by Stage and Type of Bladder Cancer

By: Joshua D. Madera, MS
Posted: Wednesday, October 27, 2021

Treatment with radical cystectomy yielded similar or worse oncologic outcomes in patients with cT1 micropapillary bladder cancer compared with patients who had cT2 conventional urothelial carcinoma, according to an study presented during the 2021 American Urological Association (AUA) Annual Meeting (Abstract PD63-11) and published in The Journal of Urology. According to lead study author Kevin Ginsburg, MD, of Fox Chase Cancer Center in Philadelphia, and colleagues, their study findings “may help patients and clinicians while debating treatment options in those with cT1 micropapillary bladder cancer.”

“The standard of care for cT2 urothelial cell bladder cancer is often treated with complete bladder removal, and we should consider treating this early stage micropapillary bladder cancer in the same aggressive manner,” Dr. Ginsburg commented in a Fox Chase press release.

From 2004 to 2016, a total of 27,453 patients with bladder carcinoma met the study inclusion criteria. A total of 20,311 patients had cT2 urothelial carcinoma, 7,017 patients had cT1 urothelial carcinoma, and 125 patients had cT1 micropapillary bladder carcinoma. All patients had undergone radical cystectomy.

The study authors reported that patients with cT1 urothelial carcinoma had improved overall survival (hazard ratio = 0.70) as compared with patients with cT2 urothelial carcinoma, whereas patients with cT1 micropapillary bladder cancer had similar overall survival (hazard ratio = 0.74). In addition, there were increased rates of node-positive disease in patients with cT1 micropapillary bladder cancer (39%) as compared with patients who had cT1 (11%) and cT2 (19%) urothelial cancers. This same trend was observed when the study investigators assessed upstaging to pT3/4 in patients with cT1 micropapillary bladder cancer (31%) when compared with patients who had cT1 (18%) and cT2 (27%) urothelial cancers.

Disclosures: For full disclosures of the study authors, visit auajournals.org.



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