Treatment Patterns and Radical Cystectomy Outcomes in Patients Diagnosed With Urothelial Nonmetastatic Muscle‐Invasive Bladder Cancer in the United States
ABSTRACT Purpose To characterize trends and patterns in treatment characteristics and perioperative outcomes of patients with urothelial muscle‐invasive bladder cancer (MIBC). Materials and Methods We utilized the National Cancer Database to assess trends and patterns in treatment modalities (radica...
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| Format: | Article |
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Wiley
2025-02-01
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| Series: | Cancer Medicine |
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| Online Access: | https://doi.org/10.1002/cam4.70644 |
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| author | Bernard Bright Davies‐Teye M. Minhaj Siddiqui Xiao Zhang Abree Johnson Mehmet Burcu Eberechukwu Onukwugha Nader Hanna |
| author_facet | Bernard Bright Davies‐Teye M. Minhaj Siddiqui Xiao Zhang Abree Johnson Mehmet Burcu Eberechukwu Onukwugha Nader Hanna |
| author_sort | Bernard Bright Davies‐Teye |
| collection | DOAJ |
| description | ABSTRACT Purpose To characterize trends and patterns in treatment characteristics and perioperative outcomes of patients with urothelial muscle‐invasive bladder cancer (MIBC). Materials and Methods We utilized the National Cancer Database to assess trends and patterns in treatment modalities (radical cystectomy [RC] with or without neoadjuvant/adjuvant treatments, trimodal bladder‐sparing treatment [trimodal treatment], and others) among MIBC patients diagnosed between 2004 and 2017. We also assessed trends and patterns of short‐term post‐surgery outcomes, including 30‐day and 90‐day mortality, and readmissions. Results Among 83,259 MIBC patients, those who received RC, trimodal treatment, and transurethral resection of bladder tumor (TURBT) plus chemotherapy were 34,715 (41.7%), 7,372 (8.9%), and 6,171 (7.4%), respectively. A substantial proportion (29,314; 35.2%) of MIBC patients received other treatments, including TURBT‐only. From 2004 through 2017, the proportion of MIBC patients who utilized guideline‐recommended treatments, whether RC (from 36.4% to 42.8%) or trimodal treatment (from 7.9% to 10.2%), increased. Among those who received RC, there was a substantial increase in neoadjuvant chemotherapy (NAC) utilization, from 7.8% to 29.4%. Conversely, utilization of RC without perioperative treatments decreased from 62.3% to 32.7%. There was a significant decrease in 30‐day (2.8%–1.8%) and 90‐day (7.1%–5.3%) mortality rates among RC recipients. Conclusion There was a shift in treatment modalities for MIBC, with increased utilization of RC with NAC. A decrease in post‐surgery mortality rates may indicate improved outcomes, although the unmet need for NAC utilization requires further investigation. |
| format | Article |
| id | doaj-art-2f2a8edc2a3f448584804cc42231e359 |
| institution | OA Journals |
| issn | 2045-7634 |
| language | English |
| publishDate | 2025-02-01 |
| publisher | Wiley |
| record_format | Article |
| series | Cancer Medicine |
| spelling | doaj-art-2f2a8edc2a3f448584804cc42231e3592025-08-20T02:13:02ZengWileyCancer Medicine2045-76342025-02-01144n/an/a10.1002/cam4.70644Treatment Patterns and Radical Cystectomy Outcomes in Patients Diagnosed With Urothelial Nonmetastatic Muscle‐Invasive Bladder Cancer in the United StatesBernard Bright Davies‐Teye0M. Minhaj Siddiqui1Xiao Zhang2Abree Johnson3Mehmet Burcu4Eberechukwu Onukwugha5Nader Hanna6Department of Practice, Sciences, and Health Outcomes Research University of Maryland School of Pharmacy Baltimore Maryland USAUniversity of Maryland School of Medicine Baltimore Maryland USAMerck & Co., Inc. Rahway New Jersey USADepartment of Practice, Sciences, and Health Outcomes Research University of Maryland School of Pharmacy Baltimore Maryland USAMerck & Co., Inc. Rahway New Jersey USADepartment of Practice, Sciences, and Health Outcomes Research University of Maryland School of Pharmacy Baltimore Maryland USAUniversity of Maryland School of Medicine Baltimore Maryland USAABSTRACT Purpose To characterize trends and patterns in treatment characteristics and perioperative outcomes of patients with urothelial muscle‐invasive bladder cancer (MIBC). Materials and Methods We utilized the National Cancer Database to assess trends and patterns in treatment modalities (radical cystectomy [RC] with or without neoadjuvant/adjuvant treatments, trimodal bladder‐sparing treatment [trimodal treatment], and others) among MIBC patients diagnosed between 2004 and 2017. We also assessed trends and patterns of short‐term post‐surgery outcomes, including 30‐day and 90‐day mortality, and readmissions. Results Among 83,259 MIBC patients, those who received RC, trimodal treatment, and transurethral resection of bladder tumor (TURBT) plus chemotherapy were 34,715 (41.7%), 7,372 (8.9%), and 6,171 (7.4%), respectively. A substantial proportion (29,314; 35.2%) of MIBC patients received other treatments, including TURBT‐only. From 2004 through 2017, the proportion of MIBC patients who utilized guideline‐recommended treatments, whether RC (from 36.4% to 42.8%) or trimodal treatment (from 7.9% to 10.2%), increased. Among those who received RC, there was a substantial increase in neoadjuvant chemotherapy (NAC) utilization, from 7.8% to 29.4%. Conversely, utilization of RC without perioperative treatments decreased from 62.3% to 32.7%. There was a significant decrease in 30‐day (2.8%–1.8%) and 90‐day (7.1%–5.3%) mortality rates among RC recipients. Conclusion There was a shift in treatment modalities for MIBC, with increased utilization of RC with NAC. A decrease in post‐surgery mortality rates may indicate improved outcomes, although the unmet need for NAC utilization requires further investigation.https://doi.org/10.1002/cam4.70644conservative treatmentcystectomy radicalneoadjuvant chemotherapytreatment outcomesurinary bladder neoplasm |
| spellingShingle | Bernard Bright Davies‐Teye M. Minhaj Siddiqui Xiao Zhang Abree Johnson Mehmet Burcu Eberechukwu Onukwugha Nader Hanna Treatment Patterns and Radical Cystectomy Outcomes in Patients Diagnosed With Urothelial Nonmetastatic Muscle‐Invasive Bladder Cancer in the United States Cancer Medicine conservative treatment cystectomy radical neoadjuvant chemotherapy treatment outcomes urinary bladder neoplasm |
| title | Treatment Patterns and Radical Cystectomy Outcomes in Patients Diagnosed With Urothelial Nonmetastatic Muscle‐Invasive Bladder Cancer in the United States |
| title_full | Treatment Patterns and Radical Cystectomy Outcomes in Patients Diagnosed With Urothelial Nonmetastatic Muscle‐Invasive Bladder Cancer in the United States |
| title_fullStr | Treatment Patterns and Radical Cystectomy Outcomes in Patients Diagnosed With Urothelial Nonmetastatic Muscle‐Invasive Bladder Cancer in the United States |
| title_full_unstemmed | Treatment Patterns and Radical Cystectomy Outcomes in Patients Diagnosed With Urothelial Nonmetastatic Muscle‐Invasive Bladder Cancer in the United States |
| title_short | Treatment Patterns and Radical Cystectomy Outcomes in Patients Diagnosed With Urothelial Nonmetastatic Muscle‐Invasive Bladder Cancer in the United States |
| title_sort | treatment patterns and radical cystectomy outcomes in patients diagnosed with urothelial nonmetastatic muscle invasive bladder cancer in the united states |
| topic | conservative treatment cystectomy radical neoadjuvant chemotherapy treatment outcomes urinary bladder neoplasm |
| url | https://doi.org/10.1002/cam4.70644 |
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