PD44-08 BENEFIT OF WHOLE-PELVIS RADIATION FOR PATIENTS WITH MUSCLE-INVASIVE BLADDER CANCER: AN INVERSE PROBABILITY TREATMENT WEIGHTED ANALYSIS

You have accessJournal of UrologyCME1 Apr 2023PD44-08 BENEFIT OF WHOLE-PELVIS RADIATION FOR PATIENTS WITH MUSCLE-INVASIVE BLADDER CANCER: AN INVERSE PROBABILITY TREATMENT WEIGHTED ANALYSIS Ronald Kool, Gautier Marcq, Alice Dragomir, Montreal Canada, Girish Kulkarni, Toronto Canada, Rodney H. Breau, Ottawa Canada, Michael Kim, Toronto Canada, Ionut Busca, Hamidreza Abdi, Ottawa Canada, Mark Dawidek, Michael Uy, Hamilton Canada, Gagan Fervaha, Nimira Alimohamed, Jonathan Izawa, Claudio Jeldres, Ricardo Rendon, Bobby Shayegan, Robert Siemens, Peter C. Black, Fabio L. Cury, and Wassim Kassouf Ronald KoolRonald Kool More articles by this author , Gautier MarcqGautier Marcq More articles by this author , Alice DragomirAlice Dragomir More articles by this author , Montreal CanadaMontreal Canada More articles by this author , Girish KulkarniGirish Kulkarni More articles by this author , Toronto CanadaToronto Canada More articles by this author , Rodney H. BreauRodney H. Breau More articles by this author , Ottawa CanadaOttawa Canada More articles by this author , Michael KimMichael Kim More articles by this author , Toronto CanadaToronto Canada More articles by this author , Ionut BuscaIonut Busca More articles by this author , Hamidreza AbdiHamidreza Abdi More articles by this author , Ottawa CanadaOttawa Canada More articles by this author , Mark DawidekMark Dawidek More articles by this author , Michael UyMichael Uy More articles by this author , Hamilton CanadaHamilton Canada More articles by this author , Gagan FervahaGagan Fervaha More articles by this author , Nimira AlimohamedNimira Alimohamed More articles by this author , Jonathan IzawaJonathan Izawa More articles by this author , Claudio JeldresClaudio Jeldres More articles by this author , Ricardo RendonRicardo Rendon More articles by this author , Bobby ShayeganBobby Shayegan More articles by this author , Robert SiemensRobert Siemens More articles by this author , Peter C. BlackPeter C. Black More articles by this author , Fabio L. CuryFabio L. Cury More articles by this author , and Wassim KassoufWassim Kassouf More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003354.08AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Pelvic lymph node irradiation is still under debate for patients with muscle-invasive bladder cancer (MIBC) planned for curative-intent radiation-based therapy (RT). Previous studies suggested bladder-only (BO)-RT was associated with non-inferior oncological outcomes compared to whole-pelvis (WP)-RT. In this study, we sought to evaluate the impact of the radiation volume (BO-RT vs. WP-RT) on main oncological outcomes in patients with MIBC. METHODS: Patients with urothelial MIBC (cT2-4aN0-2M0) who underwent curative RT at 10 academic centers across Canada were included. Patients were divided into two groups based on the RT volume: WP-RT vs. BO-RT. Inverse probability of treatment weighting (IPTW) and absolute standardized differences (ASDs) were used to balance baseline covariates across treatment groups. Regression models were used to assess the impact of the RT volume on the rates of complete response (CR) to treatment, cancer-specific survival (CSS), and overall survival OS while adjusting for potential confounding variables in the weighted cohorts. RESULTS: A total of 599 patients were analyzed, out of whom 369 (61.6%) underwent WP-RT. Patients in the WP-RT group were younger (mean age 73.2 vs. 77.4; ASD 0.41), and more likely to have an Eastern Cooperative Oncology Group performance status (ECOG PS) of 0-1 (82.1% vs. 73.5%; ASD 0.21), clinical node-positive disease (12.5% vs. 2.2%; ASD 0.40), and lymphovascular invasion (26.3% vs. 16.1%; ASD 0.25), compared to BO-RT. In addition, WP-RT patients were more commonly treated with neoadjuvant chemotherapy (20.9% vs. 10.4%; ASD 0.29) and concurrent chemotherapy (76.7% vs. 56.5%; ASD 0.44), compared to BO-RT. In the IPTW cohort, all pre-treatment covariates were well balanced across groups (ASDs<0.10). In multivariable analysis, WP-RT did not impact CR rates post-RT (OR 1.14; p=0.526) but was associated with both CSS (HR 0.66; p=0.016) and OS (HR 0.68; p=0.002), independently of other prognostic factors. Direct adjusted survival functions are shown - Figure 1. CONCLUSIONS: Our study demonstrated a significant survival benefit with the use of WP-RT compared to BO-RT in patients with MIBC treated with curative intent. Additional randomized controlled trials are needed to confirm our findings. Source of Funding: None © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e1127 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Ronald Kool More articles by this author Gautier Marcq More articles by this author Alice Dragomir More articles by this author Montreal Canada More articles by this author Girish Kulkarni More articles by this author Toronto Canada More articles by this author Rodney H. Breau More articles by this author Ottawa Canada More articles by this author Michael Kim More articles by this author Toronto Canada More articles by this author Ionut Busca More articles by this author Hamidreza Abdi More articles by this author Ottawa Canada More articles by this author Mark Dawidek More articles by this author Michael Uy More articles by this author Hamilton Canada More articles by this author Gagan Fervaha More articles by this author Nimira Alimohamed More articles by this author Jonathan Izawa More articles by this author Claudio Jeldres More articles by this author Ricardo Rendon More articles by this author Bobby Shayegan More articles by this author Robert Siemens More articles by this author Peter C. Black More articles by this author Fabio L. Cury More articles by this author Wassim Kassouf More articles by this author Expand All Advertisement PDF downloadLoading ...

Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.