Efficacy of chemotherapy on overall survival in metastatic sarcomatoid bladder cancer patients

Stefano Tappero; Gabriele Sorce; Andrea Panunzio; Lukas Hohenhorst; Cristina Cano Garcia; Mattia Luca Piccinelli; Zhe Tian; Stefano Parodi; Felix K H Chun; Markus Graefen; Alessandro Antonelli; Ottavio De Cobelli; Fred Saad; Shahrokh F Shariat; Francesco Montorsi; Nazareno R Suardi; Marco Borghesi; Carlo Terrone; Pierre I Karakiewicz

doi:10.5173/ceju.2022.142

Efficacy of chemotherapy on overall survival in metastatic sarcomatoid bladder cancer patients

Cent European J Urol. 2022;75(4):352-356. doi: 10.5173/ceju.2022.142. Epub 2022 Nov 25.

Authors

Stefano Tappero^{1

2

3}, Gabriele Sorce^{1

4}, Andrea Panunzio^{1

5}, Lukas Hohenhorst^{1

6}, Cristina Cano Garcia^{1

7}, Mattia Luca Piccinelli^{1

8}, Zhe Tian¹, Stefano Parodi^{2

3}, Felix K H Chun⁷, Markus Graefen⁶, Alessandro Antonelli⁵, Ottavio De Cobelli⁸, Fred Saad¹, Shahrokh F Shariat^{9

10}, Francesco Montorsi⁴, Nazareno R Suardi¹¹, Marco Borghesi^{2

3}, Carlo Terrone^{2

3}, Pierre I Karakiewicz¹

Affiliations

¹ Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, Québec, Canada.
² Department of Urology, IRCCS Ospedale Policlinico San Martino, Genova, Italy.
³ Department of Surgical and Diagnostic Integrated Sciences (DISC), University of Genova, Genova, Italy.
⁴ Division of Experimental Oncology/Unit of Urology, URI, Urological Research Institute, IRCCS San Raffaele Scientific Institute, Milan, Italy.
⁵ Department of Urology, University of Verona, Azienda Ospedaliera Universitaria Integrata di Verona, Verona, Italy.
⁶ Martini-Klinik Prostate Cancer Center, University Hospital Hamburg-Eppendorf, Hamburg, Germany.
⁷ Department of Urology, University Hospital Frankfurt, Goethe University Frankfurt am Main, Frankfurt am Main, Germany.
⁸ Department of Urology, IEO European Institute of Oncology, IRCCS, Milan, Italy.
⁹ Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria.
¹⁰ Hourani Center for Applied Scientific Research, Al-Ahliyya Amman University, Amman, Jordan.
¹¹ Department of Urology, Spedali Civili of Brescia, Brescia, Italy.

Abstract

Introduction: The role of chemotherapy in metastatic sarcomatoid bladder cancer (mSBC) is unknown. The current work aimed to test the effect of chemotherapy on overall survival (OS) in mSBC patients.

Material and methods: Using the Surveillance, Epidemiology and End Results database (2001-2018), we identified 110 mSBC patients of all T and N stages (T_anyN_anyM₁). Kaplan-Meier plots and Cox regression models were used. Covariates consisted of type of surgical treatment (no treatment vs radical cystectomy vs other), and patient age. The endpoint of interest was OS.

Results: In 110 mSBC patients, 46 (41.8%) were exposed to chemotherapy vs 64 (58.2%) who were chemotherapy naive. Chemotherapy exposed patients were younger (median age 66 vs 70, p = 0.005). Median OS was 8 months in chemotherapy exposed vs 2 months in chemotherapy naive patients. In univariable Cox regression models, chemotherapy exposure was associated with a hazard ratio (HR) of 0.58 (p = 0.007).In multivariable Cox regression models adjusted for case mix, chemotherapy exposure was associated with a HR of 0.60 (p = 0.016).

Conclusions: To the best of our knowledge, this is the first report of chemotherapy effect on OS in mSBC patients. OS is extremely poor. Nonetheless, it is improved in a statistically significant and clinically meaningful fashion, when chemotherapy is administered.

Keywords: bladder; cancer; chemotherapy; metastatic; sarcomatoid.

Copyright by Polish Urological Association.