1990 THE ROLE OF RADICAL SURGERY FOR METASTATIC UROTHELIAL CARCINOMA OF THE BLADDER: AN ANALYSIS OF THE SEER DATABASE (2011)

You have accessJournal of UrologyBladder Cancer: Metastatic Disease1 Apr 20111990 THE ROLE OF RADICAL SURGERY FOR METASTATIC UROTHELIAL CARCINOMA OF THE BLADDER: AN ANALYSIS OF THE SEER DATABASE Daniel Canter, Alexander Kutikov, Marc Smaldone, Brian Egleston, Yu-Ning Wong, Ervin Tepper, Rosalia Viterbo, David Chen, Richard Greenberg, and Robert G. Uzzo Daniel CanterDaniel Canter Philadelphia, PA More articles by this author , Alexander KutikovAlexander Kutikov Philadelphia, PA More articles by this author , Marc SmaldoneMarc Smaldone Philadelphia, PA More articles by this author , Brian EglestonBrian Egleston Philadelphia, PA More articles by this author , Yu-Ning WongYu-Ning Wong Philadelphia, PA More articles by this author , Ervin TepperErvin Tepper Philadelphia, PA More articles by this author , Rosalia ViterboRosalia Viterbo Philadelphia, PA More articles by this author , David ChenDavid Chen Philadelphia, PA More articles by this author , Richard GreenbergRichard Greenberg Philadelphia, PA More articles by this author , and Robert G. UzzoRobert G. Uzzo Philadelphia, PA More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2011.02.2216AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES The benefits of surgery in patients with metastatic urothelial cell carcinoma (UCC) of the bladder are unclear as the prognosis is poor. Indications for surgery and expectations of outcome are ill-defined. Using a large population-based dataset, we characterize the factors that predict for radical surgery in patients with metastatic UCC and assess whether surgery affords a survival benefit in these patients. METHODS Using the Surveillance Epidemiology and End Results (SEER) database from 2003–2006, we identified patients with metastatic UCC and stratified them by surgery status. Logistic regressions were used to investigate which sociodemographic factors correlated with treatment by surgical therapy in the face of advanced disease. Kaplan-Meier estimators and Cox regressions were used to investigate survival. RESULTS We identified 4,362 patients who underwent surgery for bladder cancer in the SEER registry from 2003 and 2006. Patients with metastatic disease represented 4.2% of the total cystectomy population; 69 (1.6%) patients had metastatic disease only and 112 (2.6%) patients had both nodal and metastatic disease. Using multiple logistic regressions, age greater than 70 years was a statistically significant predictor against surgery for patients with metastatic disease only (OR=0.24, p=0.002). Among those patients with both nodal and metastatic disease, blacks were less likely to have surgery compared to whites (OR=0.34, p=0.021) while married individuals were more likely to have surgery (OR=1.77, p=0.020). Using Cox regressions, patients who underwent surgery had a higher overall survival probability compared to patients who did not undergo surgery after controlling for age, gender, race, and marital status (HR=0.68, p=0.012, for metastatic disease and HR=0.63, p=0.002, for nodal and metastatic disease). CONCLUSIONS Using the SEER dataset, we found that younger patients with metastatic disease were more likely to have surgery. Younger, married Caucasians were more likely to have surgery in the setting of combined nodal and metastatic disease. Surgical patients in both groups appeared to enjoy improved survival, necessitating a re-evaulation of the role of surgery in this subet of patients. © 2011 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 185Issue 4SApril 2011Page: e796-e797 Advertisement Copyright & Permissions© 2011 by American Urological Association Education and Research, Inc.MetricsAuthor Information Daniel Canter Philadelphia, PA More articles by this author Alexander Kutikov Philadelphia, PA More articles by this author Marc Smaldone Philadelphia, PA More articles by this author Brian Egleston Philadelphia, PA More articles by this author Yu-Ning Wong Philadelphia, PA More articles by this author Ervin Tepper Philadelphia, PA More articles by this author Rosalia Viterbo Philadelphia, PA More articles by this author David Chen Philadelphia, PA More articles by this author Richard Greenberg Philadelphia, PA More articles by this author Robert G. Uzzo Philadelphia, PA More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...