Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montreal Health Center, Montreal, Quebec, Canada.
Division of Experimental Oncology, Department of Urology, Urological Research Institute, IRCCS San Raffaele Scientific Institute, Milan, Italy.
J Surg Oncol. 2020 Jun;121(8):1329-1336. doi: 10.1002/jso.25919. Epub 2020 Apr 4.
To investigate other-cause mortality (OCM) rates over time according to several baseline characteristics in bladder cancer (BCa) patients treated with radical cystectomy (RC).
Within the Surveillance, Epidemiology, and End Results database (1988-2011), we identified 7702 T N M urothelial BCa patients treated with RC. Temporal trends and multivariable Cox regression (MCR) analyses assessed 5-year OCM. Data were stratified according to the year of diagnosis (1988-1995 vs 1996-2000 vs 2001-2004 vs 2005-2008 vs 2009-2011), age group (<60 vs 60-75 vs >75 years), sex, race, marital status, and socioeconomic status.
Overall, OCM rates decreased from 13.9% in 1988-1995 to 8.6% in 2009-2011. The greatest decrease was recorded in elderly (>75) patients (32%-16%, slope: -0.55% per year; P = .01), followed by patients aged 60 to 75 (21%-5%, slope: -0.35% per year; P = .01), unmarried patients (16%-10%, slope: -0.26% per year; P < .001), male patients (14%-8.9%, slope: -0.23% per year), and African Americans (16%-11%, slope: -0.27% per year; P < .001). MCR models corroborated these results.
Most important decrease in OCM after RC over the last decades was recorded in the elderly, unmarried, and male patients. Nonetheless, these three patient groups still represent ideal targets for efforts aimed at minimizing the morbidity and mortality after RC, as their risk of OCM is higher than in others.
研究根治性膀胱切除术（RC）治疗的膀胱癌（BCa）患者根据基线特征随时间推移的其他原因死亡率（OCM）。
在监测、流行病学和最终结果数据库（1988-2011 年）中，我们确定了 7702 例 T N M 尿路上皮 BCa 患者接受 RC 治疗。采用 5 年 OCM 评估时间趋势和多变量 Cox 回归（MCR）分析。根据诊断年份（1988-1995 年、1996-2000 年、2001-2004 年、2005-2008 年和 2009-2011 年）、年龄组（<60 岁、60-75 岁和>75 岁）、性别、种族、婚姻状况和社会经济地位对数据进行分层。
总体而言，OCM 率从 1988-1995 年的 13.9%下降到 2009-2011 年的 8.6%。在>75 岁的老年患者中，下降幅度最大（32%-16%，斜率：每年减少 0.55%；P=0.01），其次是 60-75 岁的患者（21%-5%，斜率：每年减少 0.35%；P=0.01）、未婚患者（16%-10%，斜率：每年减少 0.26%；P<0.001）、男性患者（14%-8.9%，斜率：每年减少 0.23%；P<0.001）和非裔美国人（16%-11%，斜率：每年减少 0.27%；P<0.001）。MCR 模型证实了这些结果。
过去几十年 RC 后 OCM 最大的下降发生在老年、未婚和男性患者中。尽管如此，这三组患者仍然是努力降低 RC 后发病率和死亡率的理想目标，因为他们的 OCM 风险高于其他患者。
