Abstract
Background: The Dutch Uro-Oncology Study Group
(DUOS) is a multidisciplinary network of ~30 hospitals in
volved in research and treatment of urological cancers.
We analyzed the influence of treatment at DUOS versus
non-DUOS on survival of muscle-invasive bladder cancer
(MIBC) patients and explored correlating parameters.
Patients and methods: Characteristics of 3472 cT2
4aN0/XM0 MIBC patients who underwent radical cystec
tomy (RC), with or without neoadjuvant chemotherapy
(NAC), were collected by the Netherlands Cancer Registry
(NCR). 5-year overall survival (OS) was estimated by the
Kaplan-Meier method. Cox regression analyses were per
formed to determine hazard ratios for pre-defined variables.
Results: 5-year OS differed 3.2% in favor of DUOS centers
(49.3% vs. 46.1%, p = 0.09). Best survival was observed
in patients treated with NAC and RC at DUOS centers (5
year OS 57%). This was 61.1% in cT3-4 patients treated
at DUOS centers. NAC was only significantly associated
with improved survival in cT3-4a patients treated at DUOS
centers (p = 0.0002). Positive surgical margins were less
frequent (p = 0.02) and more pelvic lymph nodes (LNs)
were collected and identified (p = 0.001) at DUOS centers.
Surgical margins, number of identified LNs, and number of
positive LNs significantly correlated with OS.
Conclusions: We identified a greater survival benefit by
the use of NAC, a higher number of LNs identified, a lower
rate of positive surgical margins and a trend towards surviv
al benefit in patients treated at centers that collaborate in
the multidisciplinary DUOS national network.
(DUOS) is a multidisciplinary network of ~30 hospitals in
volved in research and treatment of urological cancers.
We analyzed the influence of treatment at DUOS versus
non-DUOS on survival of muscle-invasive bladder cancer
(MIBC) patients and explored correlating parameters.
Patients and methods: Characteristics of 3472 cT2
4aN0/XM0 MIBC patients who underwent radical cystec
tomy (RC), with or without neoadjuvant chemotherapy
(NAC), were collected by the Netherlands Cancer Registry
(NCR). 5-year overall survival (OS) was estimated by the
Kaplan-Meier method. Cox regression analyses were per
formed to determine hazard ratios for pre-defined variables.
Results: 5-year OS differed 3.2% in favor of DUOS centers
(49.3% vs. 46.1%, p = 0.09). Best survival was observed
in patients treated with NAC and RC at DUOS centers (5
year OS 57%). This was 61.1% in cT3-4 patients treated
at DUOS centers. NAC was only significantly associated
with improved survival in cT3-4a patients treated at DUOS
centers (p = 0.0002). Positive surgical margins were less
frequent (p = 0.02) and more pelvic lymph nodes (LNs)
were collected and identified (p = 0.001) at DUOS centers.
Surgical margins, number of identified LNs, and number of
positive LNs significantly correlated with OS.
Conclusions: We identified a greater survival benefit by
the use of NAC, a higher number of LNs identified, a lower
rate of positive surgical margins and a trend towards surviv
al benefit in patients treated at centers that collaborate in
the multidisciplinary DUOS national network.
| Original language | English |
|---|---|
| Article number | 105 |
| Pages (from-to) | 1-9 |
| Journal | Int J Cancer Clin Res |
| Volume | 6 |
| Issue number | 1 |
| Publication status | Published - 2019 |
