title: Conditional survival of patients treated with first-line chemotherapy for metastatic urothelial cancer.
abstract: BACKGROUND
  Measures of prognosis for cancer patients are typically evaluated at the time of diagnosis. However, this study assessed the changes in 2-year CS rates after first-line chemotherapy for metastatic UC.
  
  
  METHODS
  Conditional overall survival and CPFS probability were estimated using the Kaplan-Meier method. Adjusted survival functions were stratified according to age groups (< 70 years vs. ≥ 70 years), sex, Eastern Cooperative Oncology Group (ECOG) performance status (PS; ECOG PS ≤ 2 vs. ECOG PS > 2), pretreatment Hb levels (< 12 mg/dL vs. ≥ 12 mg/dL) and pretreatment NLR (< 3 vs. ≥ 3). Pairs of CS curves were compared using the Mantel-Haenszel log-rank test.
  
  
  RESULTS
  Two hundred ninety-eight patients were included in this analysis, 233 were male, and their median age was 69 years. First-line median overall survival and progression-free survival were 10.7 months (95% confidence interval [CI], 9.6-12.6) and 6.0 months (95% CI, 5.5-7.1), respectively. CPFS and COS showed an increasing trend in the population considered (b = 0.35; P < .001 and b = 0.79; P < .001, respectively). A significant increase in terms of COS and CPFS trends was identified in patients with age < 70 years (P = .02 and P = .005, respectively) and pretreatment NLR ≤ 3 (P = .05 and P < .001, respectively). Patients with Hb levels < 12 g/dL showed a significantly poorer 2-year COS.
  
  
  CONCLUSIONS
  The conditional probability of survival at 2 years from the start of first-line chemotherapy for advanced UC changes over time according to clinical characteristics.
authors.affiliation: Department of Medical Oncology, AOU Ospedali Riuniti, Università Politecnica delle Marche, Ancona, Italy. Electronic address: mattymo@alice.it.
authors.forename: Matteo
authors.initials: M
authors.lastname: Santoni
authors.affiliation: Cancer Sciences Unit, University of Southampton, Southampton, UK.
authors.forename: Simon J
authors.initials: SJ
authors.lastname: Crabb
authors.affiliation: Dipartimento di Scienze Cliniche Specialistiche ed Odontostomatologiche, Clinica di Urologia, AOU Ospedali Riuniti, Università Politecnica delle Marche, Ancona, Italy.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Conti
authors.affiliation: Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy.
authors.forename: Lorena
authors.initials: L
authors.lastname: Rossi
authors.affiliation: Department of Medical Oncology, AOU Ospedali Riuniti, Università Politecnica delle Marche, Ancona, Italy.
authors.forename: Luciano
authors.initials: L
authors.lastname: Burattini
authors.affiliation: Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy.
authors.forename: Vincenza
authors.initials: V
authors.lastname: Conteduca
authors.affiliation: NIHR Wellcome Trust Clinical Research Facility, University of Southampton, Southampton, UK.
authors.forename: Caroline
authors.initials: C
authors.lastname: Chau
authors.affiliation: Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy.
authors.forename: Salvatore L
authors.initials: SL
authors.lastname: Burgio
authors.affiliation: Dipartimento di Scienze Cliniche Specialistiche ed Odontostomatologiche, Clinica di Urologia, AOU Ospedali Riuniti, Università Politecnica delle Marche, Ancona, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Muzzonigro
authors.affiliation: Department of Medical Oncology, AOU Ospedali Riuniti, Università Politecnica delle Marche, Ancona, Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: Cascinu
authors.affiliation: Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy.
authors.forename: Ugo
authors.initials: U
authors.lastname: De Giorgi
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D005260:Female; D006454:Hemoglobins / Q000378:metabolism; D006801:Humans; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D011379:Prognosis; D012189:Retrospective Studies; D016019:Survival Analysis; D016896:Treatment Outcome; D014571:Urologic Neoplasms / Q000097:blood / Q000188:drug therapy* / Q000401:mortality* / Q000473:pathology; D019459:Urothelium / Q000187:drug effects / Q000473:pathology*
chemical_list: D000970:Antineoplastic Agents; D006454:Hemoglobins
keywords: Advanced urothelial cancer; Conditional Survival; Overall survival; Prognosis; Progression-free survival