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Radical cystectomy plus chemotherapy in patients with pure squamous cell bladder carcinoma: a population-based study

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A Letter to the Editor to this article was published on 02 January 2021

Abstract

Purpose

To test the effect of perioperative chemotherapy (CHT) on overall mortality (OM) and cancer-specific mortality (CSM) in patients with locally advanced or metastatic squamous cell carcinoma of the urinary bladder (SCC UB).

Methods

Within the Surveillance, Epidemiology and End Results database (1988–2016), we identified 1,018 SCC UB patients (664 T3–4aN0M0, 197 TanyN1–3M0 and 156 T4bN0–3 or M1), who underwent radical cystectomy with or without perioperative chemotherapy administration. Inverse probability of treatment-weighting (IPTW), Kaplan–Meier plots and Cox-regression models (CRMs) were used.

Results

CHT was administrated in 116 (17.5%) T3–4aN0M0, 77 (39.1%) TanyN1–3M0 and 47 (30.1%) T4bN0–3 or M1 patients. IPTW-adjusted 2-year cancer-specific survival (CSS) was 66.5 vs. 71.5% (p = 0.19), 60.9 vs. 29.5% (p < 0.001) and IPTW-adjusted 1-year CSS was 46.2 vs. 31.1% (p = 0.03) for CHT vs. no CHT administration in T3–4aN0M0, TanyN1–3M0 and T4bN0–3 or M1, respectively. In multivariable IPTW-adjusted CRMs, chemotherapy was an independent predictor of lower CSM in TanyN1–3M0 (HR 0.44) and in T4bN0–3 or M1 (HR 0.60), but not in T3–4aN0M0 (p = 0.6) patients. Virtually the same results were obtained on OM, as well as without IPTW-adjustment and after stratification according to age and gender.

Conclusions

The use of perioperative CHT in patients with SCC UB confers survival benefit in the presence of T4b disease, lymph node or distant metastases. Conversely, patients with locally advanced disease but negative lymph node invasion do not benefit from its use. Pending higher quality data from prospective trials, these data should encourage the use of perioperative CHT in those high-risk patient groups.

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Acknowledgements

This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.

Funding

This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.

Author information

Authors and Affiliations

  1. Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montreal Health Center, Montreal, QC, Canada

    Giuseppe Rosiello, Angela Pecoraro, Carlotta Palumbo, Sophie Knipper, Stefano Luzzago, Zhe Tian, Fred Saad & Pierre I. Karakiewicz

  2. Department of Urology and Division of Experimental Oncology, URI, Urological Research Institute, IRCCS San Raffaele Scientific Institute, Via Olgettina, 52, 20132, Milan, Italy

    Giuseppe Rosiello, Giorgio Gandaglia, Nicola Fossati, Francesco Montorsi & Alberto Briganti

  3. Department of Urology, San Luigi Gonzaga Hospital, University of Turin, Turin, Italy

    Angela Pecoraro

  4. Urology Unit, Department of Medical and Surgical Specialties, Radiological Science and Public Health, ASST Spedali Civili of Brescia, University of Brescia, Brescia, Italy

    Carlotta Palumbo

  5. Martini-Klinik Prostate Cancer Center, University Hospital Hamburg-Eppendorf, Hamburg, Germany

    Sophie Knipper

  6. Department of Urology, European Institute of Oncology, Milan, Italy

    Stefano Luzzago

  7. Department of Urology, University Hospital Frankfurt, Frankfurt am Main, Germany

    Marina Deuker

  8. Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria

    Shahrokh F. Shariat

  9. Institute of Urology and Reproductive Health, I.M. Sechenov First Moscow State Medical University, Moscow, Russia

    Shahrokh F. Shariat

Authors
  1. Giuseppe Rosiello
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  2. Angela Pecoraro
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  3. Carlotta Palumbo
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  4. Sophie Knipper
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  5. Stefano Luzzago
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  6. Marina Deuker
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  7. Zhe Tian
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  8. Giorgio Gandaglia
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  9. Nicola Fossati
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  10. Francesco Montorsi
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  11. Shahrokh F. Shariat
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  12. Fred Saad
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  13. Alberto Briganti
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  14. Pierre I. Karakiewicz
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Contributions

GR project development, data collection, data analyses, manuscript writing; AP data collection, manuscript editing; CP data collection, manuscript editing; SK data collection, manuscript editing; SL data collection, manuscript editing; MD data collection, manuscript editing; ZT data analyses; GG manuscript editing; NF manuscript editing; FM manuscript editing; SFS manuscript editing; FS manuscript editing; AB manuscript editing; PIK project development, manuscript writing.

Corresponding author

Correspondence to Giuseppe Rosiello.

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Rosiello, G., Pecoraro, A., Palumbo, C. et al. Radical cystectomy plus chemotherapy in patients with pure squamous cell bladder carcinoma: a population-based study. World J Urol 39, 813–822 (2021). https://doi.org/10.1007/s00345-020-03247-3

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  • DOI: https://doi.org/10.1007/s00345-020-03247-3

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