Do Younger Patients with Muscle-Invasive Bladder Cancer have Better Outcomes?
Abstract
:1. Introduction
2. Material and Methods
2.1. Patient Population
2.2. Follow-Up Regimen
2.3. Statistical Analysis
3. Results
3.1. Association of Age with Clinical–Pathological Characteristics
3.2. Association of Age with Disease Recurrence and Survival Outcomes
3.3. Risk Factor Analyses for Disease Recurrence and Survival Outcomes
4. Discussion
5. Conclusions
Author Contributions
Acknowledgments
Conflicts of Interest
References
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All | Young (≤50) | Elderly (≥51) | p-Value | p-Value | ||
---|---|---|---|---|---|---|
≤40 | 41–50 | ≥51 | ≤50 vs. ≥51 | ≤40 vs. 41–50 vs. ≥51 | ||
Patients, n | 669 | 8 | 39 | 622 | - | - |
Gender (%) | 0.85 | 0.98 | ||||
Male | 520 (77.7) | 6 (75.0) | 30 (76.9) | 484 (77.8) | ||
Female | 149 (22.3) | 2 (25.0) | 9 (23.1) | 138 (22.2) | ||
ASA (%) | <0.001 | <0.001 | ||||
1 | 52 (7.8) | 4 (50.0) | 7 (18.0) | 41 (6.6) | ||
2 | 386 (57.7) | 3 (37.5) | 27 (69.2) | 356 (57.2) | ||
3 | 225 (33.6) | 1 (12.5) | 3 (7.7) | 221 (35.5) | ||
4 | 6 (0.9) | 0 (0) | 2 (5.1) | 4 (0.7) | ||
Pathological Tumor Stage (%) | 0.92 | 0.34 | ||||
pT0 | 73 (10.9) | 3 (37.5) | 4 (10.3) | 66 (10.6) | ||
pTa | 26 (3.9) | 0 (0) | 1 (2.6) | 25 (4.0) | ||
pTis | 66 (9.9) | 0 (0) | 3 (7.7) | 63 (10.1) | ||
pT1 | 74 (11.1) | 1 (12.5) | 4 (10.3) | 69 (11.1) | ||
pT2 | 132 (19.7) | 0 (0) | 10 (25.6) | 122 (19.6) | ||
pT3 | 182 (27.2) | 4 (50.0) | 8 (20.5) | 170 (27.3) | ||
pT4 | 116 (17.3) | 0 (0) | 9 (23.1) | 107 (17.2) | ||
Pathological Tumor Grade (%) | 0.58 | 0.42 | ||||
No grading (pT0) | 73 (10.9) | 3 (37.5) | 4 (10.3) | 66 (10.6) | ||
G2 | 65 (9.7) | 1 (12.5) | 6 (15.4) | 58 (9.3) | ||
G3 | 531 (79.4) | 4 (50.0) | 29 (74.3) | 498 (80.1) | ||
Concomitant carcinoma in situ (%) | 0.051 | 0.12 | ||||
Absent | 424 (63.4) | 7 (87.5) | 29 (74.4) | 388 (62.4) | ||
Present | 245 (36.6) | 1 (12.5) | 10 (25.6) | 234 (37.6) | ||
Lymph node status (%) | 0.91 | 0.58 | ||||
pN0 | 479 (71.6) | 7 (87.5) | 27 (69.2) | 445 (71.5) | ||
pN+ | 190 (28.4) | 1 (12.5) | 12 (30.8) | 177 (28.5) | ||
Margin status (%) | 0.94 | 0.99 | ||||
R0 | 586 (87.6) | 7 (87.5) | 34 (87.2) | 545 (87.6) | ||
R+ | 83 (12.4) | 1 (12.5) | 5 (12.8) | 77 (12.4) | ||
Lymphovascular invasion (%) | 0.52 | 0.62 | ||||
L0 | 455 (68.0) | 6 (75) | 24 (61.5) | 425 (68.3) | ||
L1 | 214 (32.0) | 2 (25) | 15 (38.5) | 197 (31.7) | ||
Adjuvant Chemotherapy (%) | 0.089 | 0.21 | ||||
No | 522 (78.0) | 6 (75.0) | 26 (66.7) | 490 (78.8) | ||
Yes | 147 (22.0) | 2 (25.0) | 13 (33.3) | 132 (21.2) |
Age Stratifications | RFS | CSS | OS | ||||||
---|---|---|---|---|---|---|---|---|---|
HR | 95%CI | p-Value | HR | 95%CI | p-Value | HR | 95%CI | p-Value | |
Continuous age | 1.017 | 1.002–1.032 | 0.029 | 1.023 | 1.007–1.039 | 0.005 | 1.030 | 1.016–1.044 | <0.001 |
Median Age | 1.454 | 1.095–1.932 | 0.010 | 1.550 | 1.150–2.088 | 0.004 | 1.663 | 1.299–2.129 | <0.001 |
Age ≤50 vs. >50 | 1.227 | 0.684–2.202 | 0.49 | 1.084 | 0.616–1.909 | 0.78 | 1.107 | 0.693–1.767 | 0.67 |
Age (three categories) | |||||||||
≤40 vs. >50 | 0.818 | 0.179–3.733 | 0.80 | 0.910 | 0.202–4.111 | 0.90 | 0.832 | 0.242–2.858 | 0.77 |
41–50 vs. >50 | 1.035 | 0.257–4.170 | 0.96 | 1.001 | 0.248–4.038 | 0.99 | 0.946 | 0.303–2.955 | 0.92 |
Age (Tertiles) | |||||||||
first vs. third tertile | 1.242 | 0.861–1.793 | 0.25 | 1.364 | 0.926–2.008 | 0.12 | 1.576 | 1.137–2.185 | 0.006 |
second vs. third tertile | 1.699 | 1.151–2.507 | 0.008 | 1.931 | 1.278–2.917 | 0.002 | 2.194 | 1.546–3.112 | <0.001 |
Age Stratifications | RFS | CSS | OS | ||||||
---|---|---|---|---|---|---|---|---|---|
HR | 95%CI | p-Value | HR | 95%CI | p-Value | HR | 95%CI | p-Value | |
Continuous Age | 1.019 | 1.003–1.035 | 0.018 | 1.025 | 1.008–1.042 | 0.004 | 1.030 | 1.016–1.045 | 0.000 |
Median age | 1.472 | 1.081–2.005 | 0.014 | 1.553 | 1.124–2.146 | 0.008 | 1.596 | 1.225–2.080 | 0.001 |
Age (Tertiles) | |||||||||
first vs. third tertile | 1.339 | 0.914–1.962 | 0.13 | 1.545 | 1.033–2.312 | 0.034 | 1.728 | 1.230–2.428 | 0.002 |
second vs. third tertile | 1.862 | 1.211–2.864 | 0.005 | 2.085 | 1.328–3.276 | 0.001 | 2.256 | 1.541–3.304 | <0.001 |
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Janisch, F.; Yu, H.; Vetterlein, M.W.; Dahlem, R.; Engel, O.; Fisch, M.; Shariat, S.F.; Soave, A.; Rink, M. Do Younger Patients with Muscle-Invasive Bladder Cancer have Better Outcomes? J. Clin. Med. 2019, 8, 1459. https://doi.org/10.3390/jcm8091459
Janisch F, Yu H, Vetterlein MW, Dahlem R, Engel O, Fisch M, Shariat SF, Soave A, Rink M. Do Younger Patients with Muscle-Invasive Bladder Cancer have Better Outcomes? Journal of Clinical Medicine. 2019; 8(9):1459. https://doi.org/10.3390/jcm8091459
Chicago/Turabian StyleJanisch, Florian, Hang Yu, Malte W. Vetterlein, Roland Dahlem, Oliver Engel, Margit Fisch, Shahrokh F. Shariat, Armin Soave, and Michael Rink. 2019. "Do Younger Patients with Muscle-Invasive Bladder Cancer have Better Outcomes?" Journal of Clinical Medicine 8, no. 9: 1459. https://doi.org/10.3390/jcm8091459