Disease-Free Survival at 2 or 3 Years Correlates With 5-Year Overall Survival of Patients Undergoing Radical Cystectomy for Muscle Invasive Bladder Cancer

No AccessJournal of UrologyAdult Urology1 Feb 2011Disease-Free Survival at 2 or 3 Years Correlates With 5-Year Overall Survival of Patients Undergoing Radical Cystectomy for Muscle Invasive Bladder Cancer Guru Sonpavde, Myrna M. Khan, Seth P. Lerner, Robert S. Svatek, Giacomo Novara, Pierre I. Karakiewicz, Eila Skinner, Derya Tilki, Wassim Kassouf, Yves Fradet, Colin P. Dinney, Hans-Martin Fritsche, Jonathan I. Izawa, Patrick J. Bastian, Vincenzo Ficarra, Mark Schoenberg, Arthur I. Sagalowsky, Yair Lotan, and Shahrokh F. Shariat Guru SonpavdeGuru Sonpavde Michael E. DeBakey Veterans Affairs Medical Center, Houston, Texas Department of Medicine, Baylor College of Medicine, Houston, Texas Urology, Baylor College of Medicine, Houston, Texas Texas Oncology, University of Texas M.D., Houston, Texas , Myrna M. KhanMyrna M. Khan Michael E. DeBakey Veterans Affairs Medical Center, Houston, Texas Department of Medicine, Baylor College of Medicine, Houston, Texas , Seth P. LernerSeth P. Lerner Urology, Baylor College of Medicine, Houston, Texas , Robert S. SvatekRobert S. Svatek Anderson Cancer Center, Houston, Texas , Giacomo NovaraGiacomo Novara University of Padua, Padua, Italy , Pierre I. KarakiewiczPierre I. Karakiewicz University of Montréal, Montréal, Québec, Canada , Eila SkinnerEila Skinner University of Southern California, Los Angeles, California , Derya TilkiDerya Tilki Ludwig-Maximilians-Universität München, Klinikum Grosshadern, Munich, Germany , Wassim KassoufWassim Kassouf McGill University Health Centre, Montréal, Québec, Canada , Yves FradetYves Fradet Laval University, Québec City, Québec, Canada , Colin P. DinneyColin P. Dinney Anderson Cancer Center, Houston, Texas , Hans-Martin FritscheHans-Martin Fritsche University of Regensburg, Regensburg, Germany , Jonathan I. IzawaJonathan I. Izawa University of Western Ontario, London, Ontario, Canada , Patrick J. BastianPatrick J. Bastian Ludwig-Maximilians-Universität München, Klinikum Grosshadern, Munich, Germany , Vincenzo FicarraVincenzo Ficarra University of Padua, Padua, Italy , Mark SchoenbergMark Schoenberg Johns Hopkins University, Baltimore, Maryland , Arthur I. SagalowskyArthur I. Sagalowsky University of Texas Southwestern Medical Center, Dallas, Texas , Yair LotanYair Lotan University of Texas Southwestern Medical Center, Dallas, Texas , and Shahrokh F. ShariatShahrokh F. Shariat Department of Urology, Weill Cornell Medical Center, New York, New York View All Author Informationhttps://doi.org/10.1016/j.juro.2010.09.110AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: The conventional primary end point in trials of perioperative systemic therapy for muscle invasive bladder cancer is 5-year overall survival. We identified an association between disease-free survival at 2 to 3 years and 5-year overall survival. Materials and Methods: We retrospectively analyzed a multicenter database containing records of 2,724 patients treated with radical cystectomy for muscle invasive bladder cancer with negative margins. Of these patients 844 had received adjuvant chemotherapy. We evaluated the association of disease-free survival at 2 and 3 years with overall survival at 5 years using Cox proportional hazards modeling and the kappa statistic. Results: Overall 2-year/3-year disease-free survival was 0.63/0.57 and 5-year overall survival was 0.47. The overall agreement between 2-year disease-free survival and 5-year overall survival was 79%, and between 3-year disease-free survival and 5-year overall survival was 81%. Agreements were similar when analyzed within pathological substages, radical cystectomy decades and adjuvant chemotherapy subgroups. The kappa statistic was 0.57 (95% CI 0.53–0.60) for 2-year disease-free survival/5-year overall survival and 0.61 (95% CI 0.58–0.64) for 3-year disease-free survival/5-year overall survival, indicating moderate agreement. The hazard ratio for disease-free survival as a time dependent variable was 12.7 (95% CI 11.60–13.90), indicating a strong relationship between disease-free and overall survival. Conclusions: Disease-free survival rates at 2 and 3 years correlate with and are potential intermediate surrogates for 5-year overall survival in patients treated with radical cystectomy for muscle invasive bladder cancer regardless of adjuvant chemotherapy. These data warrant external validation and may expedite the development of adjuvant systemic therapy. In addition, they may be applicable to the neoadjuvant setting. References 1 : Cancer statistics, 2010. CA Cancer J Clin2010; 60: 277. 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Google Scholar © 2011 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetailsCited ByWei L, Hussein A, Ma Y, Azabdaftari G, Ahmed Y, Wong L, Hu Q, Luo W, Cranwell V, Bunch B, Kozlowski J, Singh P, Glenn S, Smith G, Johnson C, Liu S and Guru K (2019) Accurate Quantification of Residual Cancer Cells in Pelvic Washing Reveals Association with Cancer Recurrence Following Robot-Assisted Radical CystectomyJournal of Urology, VOL. 201, NO. 6, (1105-1114), Online publication date: 1-Jun-2019.Hussein A, Saar M, May P, Wijburg C, Richstone L, Wagner A, Wilson T, Yuh B, Redorta J, Dasgupta P, Khan M, Menon M, Peabody J, Hosseini A, Gaboardi F, Mottrie A, Rha K, Hemal A, Stockle M, Kelly J, Maatman T, Canda A, Wiklund P and Guru K (2018) Early Oncologic Failure after Robot-Assisted Radical Cystectomy: Results from the International Robotic Cystectomy ConsortiumJournal of Urology, VOL. 197, NO. 6, (1427-1436), Online publication date: 1-Jun-2017.Chang S (2018) Re: Conditional Survival after Radical Cystectomy for Bladder Cancer: Evidence for a Patient Changing Risk Profile over TimeJournal of Urology, VOL. 195, NO. 3, (610-611), Online publication date: 1-Mar-2016.Linder B, Boorjian S, Hudolin T, Cheville J, Thapa P, Tarrell R and Frank I (2018) Late Recurrence after Radical Cystectomy: Patterns, Risk Factors and OutcomesJournal of Urology, VOL. 191, NO. 5, (1256-1261), Online publication date: 1-May-2014.Ehdaie B, Maschino A, Shariat S, Rioja J, Hamilton R, Lowrance W, Poon S, Al-Ahmadie H and Herr H (2018) Comparative Outcomes of Pure Squamous Cell Carcinoma and Urothelial Carcinoma With Squamous Differentiation in Patients Treated With Radical CystectomyJournal of Urology, VOL. 187, NO. 1, (74-79), Online publication date: 1-Jan-2012.Chang S (2015) Re: Conditional Survival after Radical Cystectomy for Bladder Cancer: Evidence for a Patient Changing Risk Profile over TimeJournal of Urology, Volume 185Issue 2February 2011Page: 456-461 Advertisement Copyright & Permissions© 2011 by American Urological Association Education and Research, Inc.Keywordscystectomydisease-free survivalurinary bladder neoplasmsMetricsAuthor Information Guru Sonpavde Michael E. DeBakey Veterans Affairs Medical Center, Houston, Texas Department of Medicine, Baylor College of Medicine, Houston, Texas Urology, Baylor College of Medicine, Houston, Texas Texas Oncology, University of Texas M.D., Houston, Texas Financial interest and/or other relationship with Sanofi-Aventis, Novartis and Pfizer-Wyeth. More articles by this author Myrna M. Khan Michael E. DeBakey Veterans Affairs Medical Center, Houston, Texas Department of Medicine, Baylor College of Medicine, Houston, Texas More articles by this author Seth P. Lerner Urology, Baylor College of Medicine, Houston, Texas More articles by this author Robert S. Svatek Anderson Cancer Center, Houston, Texas More articles by this author Giacomo Novara University of Padua, Padua, Italy More articles by this author Pierre I. Karakiewicz University of Montréal, Montréal, Québec, Canada More articles by this author Eila Skinner University of Southern California, Los Angeles, California More articles by this author Derya Tilki Ludwig-Maximilians-Universität München, Klinikum Grosshadern, Munich, Germany More articles by this author Wassim Kassouf McGill University Health Centre, Montréal, Québec, Canada More articles by this author Yves Fradet Laval University, Québec City, Québec, Canada More articles by this author Colin P. Dinney Anderson Cancer Center, Houston, Texas More articles by this author Hans-Martin Fritsche University of Regensburg, Regensburg, Germany More articles by this author Jonathan I. Izawa University of Western Ontario, London, Ontario, Canada More articles by this author Patrick J. Bastian Ludwig-Maximilians-Universität München, Klinikum Grosshadern, Munich, Germany More articles by this author Vincenzo Ficarra University of Padua, Padua, Italy More articles by this author Mark Schoenberg Johns Hopkins University, Baltimore, Maryland More articles by this author Arthur I. Sagalowsky University of Texas Southwestern Medical Center, Dallas, Texas Financial interest and/or other relationship with Bioniche/Parexel. More articles by this author Yair Lotan University of Texas Southwestern Medical Center, Dallas, Texas Financial interest and/or other relationship with Abbott and Inverness. More articles by this author Shahrokh F. Shariat Department of Urology, Weill Cornell Medical Center, New York, New York More articles by this author Expand All Advertisement PDF DownloadLoading ...