Have Progression-Free Survival and Cancer-Specific Survival in Bladder Tumors Changed in Recent Decades?

Abstract

Background: To find out whether, despite greater surgical experience and lower perioperative mortality, PFS (progression free survival) and CSS (cancer-specific survival) due to bladder tumors have undergone variations in the last 30 years and the attributable causes. An objective is also to determine which risk factors can influence the evolution of muscle invasive bladder cancer (MIBC).

Methods: A retrospective study of 599 patients who underwent radical cystectomy between 1975 and 2007. Firstly we performed a study of the conduct of all the studied variables throughout the nearly four decades studied. In order to determine which factors could predict progression and death due to bladder tumors a univariate and multivariate study was performed on the 563 patients who underwent radical cystectomy.

Results: No differences were observed in PFS nor CSS over the four periods studied. On the contrary if there has been a decrease in surgical complications. Only two variables retained independent prognostic value in multivariate analysis both in PFS and CSS; pathological organ confinement and lymph node involvement.

Conclusions: No significant differences were observed in progression free survival and in cancer- specific survival in patients who underwent cystectomy for bladder cancer over the four periods studied. Non organ confinement and lymph node involvement in the radical cystectomy specimen are the factors that maintain independent prognostic value for cancer-specific survival and progression-free survival in the multi-variate analysis.




doi: http://dx.doi.org/10.4021/wjnu92w