PD51-12 WHOLE-PELVIS COMPARED TO BLADDER-ONLY RADIATION THERAPY PROLONGS OVERALL SURVIVAL IN MUSCLE-INVASIVE BLADDER CANCER PATIENTS: RESULTS FROM A CANADIAN MULTI-CENTER COLLABORATIVE STUDY
Bibliographic record
Abstract
You have accessJournal of UrologyBladder Cancer: Invasive III (PD51)1 Sep 2021PD51-12 WHOLE-PELVIS COMPARED TO BLADDER-ONLY RADIATION THERAPY PROLONGS OVERALL SURVIVAL IN MUSCLE-INVASIVE BLADDER CANCER PATIENTS: RESULTS FROM A CANADIAN MULTI-CENTER COLLABORATIVE STUDY Ronald Kool, Gautier Marcq, Ionut Busca, Hamidreza Abdi, Rodney Breau, Mark Dawidek, Peter Black, Gagan Fervaha, Robert Siemens, Nimira Alimohamed, Claudio Jeldres, Michael Uy, Bobby Shayegan, Jonathan Izawa, Michael Kim, Girish Kulkarni, and Wassim Kassouf Ronald KoolRonald Kool More articles by this author , Gautier MarcqGautier Marcq More articles by this author , Ionut BuscaIonut Busca More articles by this author , Hamidreza AbdiHamidreza Abdi More articles by this author , Rodney BreauRodney Breau More articles by this author , Mark DawidekMark Dawidek More articles by this author , Peter BlackPeter Black More articles by this author , Gagan FervahaGagan Fervaha More articles by this author , Robert SiemensRobert Siemens More articles by this author , Nimira AlimohamedNimira Alimohamed More articles by this author , Claudio JeldresClaudio Jeldres More articles by this author , Michael UyMichael Uy More articles by this author , Bobby ShayeganBobby Shayegan More articles by this author , Jonathan IzawaJonathan Izawa More articles by this author , Michael KimMichael Kim More articles by this author , Girish KulkarniGirish Kulkarni More articles by this author , and Wassim KassoufWassim Kassouf More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002078.12AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Previous randomized data failed to show a clear oncological benefit of whole-pelvis (WP-RT) compared to bladder-only radiation (BO-RT) in highly selected patients with non-metastatic muscle-invasive bladder cancer (MIBC) undergoing chemoradiation. Our objective was to evaluate the impact of WP-RT vs. BO-RT on overall survival (OS) in an unselect population of MIBC patients treated with RT-based bladder preserving therapy. METHODS: We conducted a collaborative Canadian study of 943 non-metastatic MIBC patients (cT2-4b, cN0-3, M0) who underwent bladder-preserving RT-based therapy with curative intent (≥40Gy) at 10 academic centers across Canada. Baseline clinico-pathological characteristics and follow-up data were collected. Kaplan-Meier survival estimates were performed. A multivariable Cox regression model was used to explore independent predictors of OS. RESULTS: Median age was 77 years [IQR 68-82], 694 (74%) patients were males. A total of 719 patients (76%) were cT2, 220 (24%) cT3-4b, 90 (10%) were N+, and 188 (20%) had concomitant CIS. WP-RT was delivered to 552 (52%) patients. At 3 months post RT, 71% had a complete response (CR). Median follow-up was 54 months (95% CI 49-58) and 439 patients (46.6%) died. Median time to death was 52 months (95% CI 44-66). On multivariable analysis, WP-RT was associated with prolonged OS (HR 0.61, p<0.001), independently of age (HR 1.03, p=0.004), ECOG (HR 1.80, p<0.001), high cT stage (HR 1.39, p=0.035), presence of hydronephrosis (HR 1.59, p=0.007) and CR (HR 0.55, p<0.001). CONCLUSIONS: WP-RT is associated with improved OS in MIBC patients undergoing bladder-preserving therapy. Prospective trials are needed to validate these findings, as RT-based therapy is increasingly utilized in patients with higher risk MIBC. Source of Funding: None © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e910-e910 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Ronald Kool More articles by this author Gautier Marcq More articles by this author Ionut Busca More articles by this author Hamidreza Abdi More articles by this author Rodney Breau More articles by this author Mark Dawidek More articles by this author Peter Black More articles by this author Gagan Fervaha More articles by this author Robert Siemens More articles by this author Nimira Alimohamed More articles by this author Claudio Jeldres More articles by this author Michael Uy More articles by this author Bobby Shayegan More articles by this author Jonathan Izawa More articles by this author Michael Kim More articles by this author Girish Kulkarni More articles by this author Wassim Kassouf More articles by this author Expand All Advertisement Loading ...
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.004 | 0.006 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.003 |
| Bibliometrics | 0.001 | 0.003 |
| Science and technology studies | 0.002 | 0.001 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.002 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".