MP32-15: Management trends and oncological outcomes in bladder cancer patients undergoing radical cystectomy during 2013-2019 in Japan: a multicenter cohort study
Introduction: To assess real-world management trends and oncological outcomes in bladder cancer patients undergoing radical cystectomy (RC) in Japan. Methods: A retrospective database registered 2674 patients treated with RC in 36 institutions (Japan Urological Oncology Group) between 2013 and 2019 was reviewed. Outcomes included non-urinary tract recurrence-free survival (NUTRFS), cancer-specific survival (CSS), and overall survival (OS). Kaplan-Meier plots, log-rank tests, and Receiver operating characteristic analysis were used to assess the ability to predict the non-urinary tract recurrence by clinical stage. Results: The median age at surgery was 71.2 years, and 34.6% of patients had extravesical and nodal metastases. Neoadjuvant and adjuvant chemotherapy were administrated in 47.6% and 14.2%, respectively, and standard or wide template pelvic lymph node dissection was performed in 86.8%. The non-urinary tract recurrence and cancer-specific death were observed in 33% and 20.7% of the patients, and the cumulative event reached 80% at 19.7 and 35.3 months postoperatively. The probability of 5-year NUTRFS, CSS, and OS probabilities were 63.3%, 75.3%, and 69.1%, respectively. Kaplan-Meier curves on NUTRFS stratified by clinical stage clearly demonstrated that the high stage can lead to a higher non-urinary tract recurrence rate (p < 0.01). The accuracy of predicting recurrence for the clinical stage was 40.1% and the area under the curve was 61.8%. Conclusions: Our real-world experience shows the natural history after RC in Japan and highlights the importance of early diagnosis before progression to reduce the recurrence for BC patients undergoing RC. SOURCE OF Funding: none
