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. 2017 Mar 25;8(40):68996-69004.
doi: 10.18632/oncotarget.16576. eCollection 2017 Sep 15.

Comparison of outcomes between trimodal therapy and radical cystectomy in muscle-invasive bladder cancer: a propensity score matching analysis

Yeon Joo Kim  1 , Sang Jun Byun  1 , Hanjong Ahn  2 , Choung-Soo Kim  2 , Beom-Sik Hong  2 , Sangjun Yoo  2 , Jae-Lyun Lee  3 , Young Seok Kim  1
Affiliations

Comparison of outcomes between trimodal therapy and radical cystectomy in muscle-invasive bladder cancer: a propensity score matching analysis

Yeon Joo Kim et al. Oncotarget. .

Abstract

Although radical cystectomy (RC) is considered as the standard therapy for muscle-invasive bladder cancer (MIBC), trimodal therapy (TMT) combining transurethral resection of the tumor with radiotherapy and chemotherapy is increasingly recommended as an alternative approach for bladder preservation. In the absence of randomized trials, we compared the clinical outcomes between RC and TMT using propensity score matching with 50 patients in the RC arm and 29 patients in the TMT arm. With respective median follow-up periods of 23 and 32 months for the RC and TMT groups, 5-year distant metastasis-free survival (58% vs. 67%), overall survival (56% vs. 57%), and cancer-specific survival (69% vs. 63%) rates between the RC and TMT groups, respectively, were similar. However, the 5-year local recurrence-free survival was significantly better in the RC group than in the TMT group (74% vs. 35%). Following TMT, acute grade 3 hematological (n = 2) and late grade 3 genitourinary (n = 1) toxicities were reported. These findings demonstrated that oncological outcomes of TMT were comparable with those of RC, except for poorer local control. Large-scale, randomized trials are warranted to confirm the findings of the present retrospective comparison and to guide toward best treatment options.

Keywords: chemotherapy; muscle-invasive bladder cancer; radical cystectomy; radiotherapy; trimodal therapy.

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Conflict of interest statement

CONFLICTS OF INTEREST All authors declared that there is no conflict of interest.

Figures

Figure 1
Figure 1. Overall survival in patients with muscle-invasive bladder cancer before propensity score matching
HR, hazard ratio; CI, confidence interval; TMT, trimodal therapy; RC, radical cystectomy.
Figure 2
Figure 2. Survival rates in patients with muscle-invasive bladder cancer after propensity score matching: A. local recurrence-free survival, B. distant metastasis-free survival, C. overall survival, and D. cancer-specific survival
HR, hazard ratio; CI, confidence interval; TMT, trimodal therapy; RC, radical cystectomy
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