Muscle invasive bladder cancer - survival and health care burden in patients treated with non-curative intent

You have accessJournal of UrologyCME1 Apr 2023MP46-16 MUSCLE INVASIVE BLADDER CANCER - SURVIVAL AND HEALTH CARE BURDEN IN PATIENTS TREATED WITH NON-CURATIVE INTENT Haim Herzberg, Yossi Ventura, Idan Zeeman, Shay Golan, Ofer Yossepowitch, and Roy Mano Haim HerzbergHaim Herzberg More articles by this author , Yossi VenturaYossi Ventura More articles by this author , Idan ZeemanIdan Zeeman More articles by this author , Shay GolanShay Golan More articles by this author , Ofer YossepowitchOfer Yossepowitch More articles by this author , and Roy ManoRoy Mano More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003292.16AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Muscle-invasive bladder cancer (MIBC) in an aggressive disease; yet, many patients, especially those with advanced age and multiple comorbidities, do not receive optimal care. We evaluated the disease course of MIBC patients treated without curative-intent. METHODS: Bi-center, retrospective analysis of patients diagnosed with non-metastatic MIBC who did not undergo radical cystectomy or standard chemoradiation between 2016-2021. Patient characteristics and treatment burden were described. Metastasis free and overall survivals were estimated using the Kaplan-Meier method. RESULTS: The study cohort included a total of 66 patients at a median age of 86 years (IQR 78, 90). Thirty-two patients (48%) presented with locally advanced disease. Median Charlson comorbidity index at diagnosis was 7 (IQR 6,8). Patients were not treated with curative intent due to comorbidities and low performance status in 58 patients (88%) and patient refusal in 8 (12%). Median follow-up for survivors was 29 months (IQR 15, 52). Estimated metastasis free survival was 25% in one year and 14% in 2-years. Estimated overall survival was 32% in one year and 12% in 2-years. During follow-up patients received the following treatments: Chemotherapy 7 patients (11%), Immunotherapy 4 patients (6%), and radiation (without concurrent chemotherapy) 21 patients (32%). Forty-three patients (65%) suffered recurrent hematuria episodes and 17 (26%) required an emergent operation due to bleeding. Twenty-four patients (36%) required a nephrostomy tube and 39 (59%) required an indwelling urinary catheter. Overall, median emergency room visits number was 4 (IQR 2,5), and median overall admission length was 16 days (IQR 9,29). CONCLUSIONS: Untreated muscle invasive bladder cancer is associated with a high overall mortality rate and high disease burden for the patient and the health system, alike. Patients should be aware of these findings when curative intent treatment is avoided. Source of Funding: None © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e638 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Haim Herzberg More articles by this author Yossi Ventura More articles by this author Idan Zeeman More articles by this author Shay Golan More articles by this author Ofer Yossepowitch More articles by this author Roy Mano More articles by this author Expand All Advertisement PDF downloadLoading ...