title: Prognostic factors for survival in patients with recurrence of muscle invasive bladder cancer after treatment with curative intent.
abstract: Prognostic factors for survival after recurrent MIBC are unknown and were evaluated using a population-based series of 1409 MIBC patients. 330 Patients who underwent RC or RT with curative intent and who suffered from recurrence were selected. Multivariable survival analyses were performed. Clinicopathological factors that predict survival after recurrence are recurrence location, treatment for recurrence and age at recurrence diagnosis.
  
  
  OBJECTIVE
  We conducted this study to evaluate the prognostic factors for survival among patients with recurrent muscle-invasive bladder cancer (MIBC) after initial treatment with curative intent.
  
  
  METHODS
  Clinical data were collected from a population-based series of 1409 patients with MIBC. We selected 330 patients who underwent radical cystectomy (RC) or radiotherapy (RT) for urothelial carcinoma with curative intent and who experienced recurrence. Multivariate survival analyses were performed with death from MIBC as the endpoint. Covariates were gender, time to recurrence, age at diagnosis of recurrence, recurrence multiplicity, localization, and treatment for recurrence. Analyses were performed separately for patients initially treated with RC (i-RC) or external beam radiotherapy (i-EBRT).
  
  
  RESULTS
  Patients with recurrence after i-RC showed a 1- and 3-year survival of 17% and 6%, respectively. Localization and treatment for recurrence were significantly associated with survival. Patients with recurrence after i-EBRT showed a 1- and 3-year survival of 31% and 12%, respectively. Age at diagnosis of recurrence, localization, and treatment for recurrence were significantly associated with survival.
  
  
  CONCLUSIONS
  This study confirms the extremely poor prognosis after recurrence of MIBC in patients initially treated with surgery or RT. Clinicopathologic factors that predict survival after disease recurrence are location of recurrence, treatment for recurrence, and age at diagnosis of recurrence. Improved diagnosis of primary MIBC to detect extravesical disease and more effective therapeutic approaches to target recurrent MIBC are needed.
authors: Department of Urology, Radboud University Nijmegen Medical Centre, The Netherlands.
authors: Martine
authors: M
authors: Ploeg
authors: Arjen C
authors: AC
authors: Kums
authors: Katja K
authors: KK
authors: Aben
authors: Emile N
authors: EN
authors: van Lin
authors: Geert
authors: G
authors: Smits
authors: Henk
authors: H
authors: Vergunst
authors: Andre C
authors: AC
authors: Viddeleer
authors: Arnold D
authors: AD
authors: Geboers
authors: Hans
authors: H
authors: van Berkel
authors: Erika
authors: E
authors: van Boven
authors: Lambertus A
authors: LA
authors: Kiemeney
authors: Fred
authors: F
authors: Witjes
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002277:Carcinoma / Q000401:mortality / Q000473:pathology* / Q000628:therapy; D018450:Disease Progression; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009364:Neoplasm Recurrence, Local / Q000401:mortality / Q000473:pathology* / Q000628:therapy; D011379:Prognosis; D001749:Urinary Bladder Neoplasms / Q000401:mortality / Q000473:pathology* / Q000628:therapy