Cytoreductive Cystectomy May Improve Overall Survival in Patients With mUC

Patients with metastatic urothelial carcinoma (mUC) may benefit from cytoreductive cystectomy (CRC), according to a recent study presented by Dr. Vincent Eric Xu at the 24th Annual Meeting of the Society of Urologic Oncology.

The study reported that patients treated with CRC in combination with multiagent chemotherapy had increased overall survival (OS).

Dr. Xu and colleagues conducted a retrospective analysis of patients with mUC who underwent multiagent chemotherapy using data from the National Cancer Database. They categorized patient data based on treatment status, such as if patients received additional CRC or conservative local treatment (CLT), transurethral resection of bladder tumor, radiation, or no local treatment.

To determine the propensity scores (PS) for CRC, researchers used binary logistic regression. They then conducted a 1-to-1 PS match. Of the participating patients, 247 were treated with CRC, while 251 were treated with CLT.

Investigators found that the patient groups less likely to receive CRC included Black patients (odds ratio [OR], 0.541; P=.048), older patients (OR, 0.978; P=.012), and patients with cN1+ mUC (OR, 0.663; P=.001). Demographic groups more likely to receive CRC included those who underwent treatment at academic facilities (OR, 1.449; P=.013), those who did not live close to their treatment facilities (OR, 2.077; P=.001), and those with more locally progressed tumors (OR, 1.997; P=.001).

Treatment with CRC increased OS in patients with mUC (P<.001). CRC also demonstrated improved OS when compared with patients who received CLT (hazard ratio [HR], 0.477; P<.001).

Patients with mUC and organ metastases (HR, 3.563; P=.034) or N+ disease (HR, 2.579; P=.009) who received CRC faced an increased mortality risk.

Researchers concluded that CRC combined with multiagent chemotherapy shows potential in improving OS for patients with mUC. “Our subgroup analysis suggests that patients with N+ tumors or organ metastases have worse outcomes with CRC, indicating that cN0 patients and those with mUC limited to distant LNs (cM1a) might be better candidates for CRC,” they wrote.