Impact of age on outcomes of patients with non-muscle-invasive bladder cancer treated with immediate postoperative instillation of mitomycin C

Evanguelos Xylinas, Matthew Kent, Yohann Dabi, Malte Rieken, Luis A. Kluth, Bashir Al Hussein Al Awamlh, Idir Ouzaid, Armin Pycha, Evi Comploj, Robert Svatek, Yair Lotan, Pierre I. Karakiewicz, Sten Holmang, Shahrokh F. Shariat

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Objectives: To evaluate whether age affects the clinical benefit afforded by immediate postoperative intravesical instillation of mitomycin C in a contemporary cohort of patients with NMIBC. Patients and methods: A total of 4,258 patients with NMIBC treated with transurethral resection of the bladder with (n = 2,605, 61%) or without (n = 1,652, 39%) one immediate instillation of mitomycin C from 5 institutions (study period: 2000-2007) were included. No patients received adjuvant instillations. A multivariable Cox proportional hazards regression model adjusting for standard clinical and pathological features tested the potential interaction term between age and administration of mitomycin C with regard to disease recurrence. Results: A total of 2,063 patients experienced disease recurrence with a median follow-up of 48 months for those who did not recur. In multivariable Cox regression analysis, immediate postoperative instillation of mitomycin C (HR: 0.62; 95% CI: 0.56-0.68; P<0.0001) and age (HR: 1.04; 95% CI: 1.00-1.09; P = 0.036) were associated with disease recurrence. We observed only slight decreases in recurrence-free survival with age irrespective of treatment administration of mitomycin C or not. Conclusion: We confirmed reduced disease recurrence rates associated with 1 immediate postoperative intravesical instillation of mitomycin C in NMIBC patients. The benefit on recurrence-free survival of a postoperative intravesical instillation was preserved across all ages and therefore age by itself should not be taken into consideration when deciding to use it.

Original languageEnglish (US)
JournalUrologic Oncology: Seminars and Original Investigations
DOIs
StateAccepted/In press - Jan 1 2017
Externally publishedYes

Fingerprint

Mitomycin
Urinary Bladder Neoplasms
Intravesical Administration
Recurrence
Survival
Proportional Hazards Models
Urinary Bladder
Regression Analysis

Keywords

  • Age
  • Bladder cancer
  • Chemotherapy
  • Elderly
  • Immediate instillation

ASJC Scopus subject areas

  • Oncology
  • Urology

Cite this

Impact of age on outcomes of patients with non-muscle-invasive bladder cancer treated with immediate postoperative instillation of mitomycin C. / Xylinas, Evanguelos; Kent, Matthew; Dabi, Yohann; Rieken, Malte; Kluth, Luis A.; Al Awamlh, Bashir Al Hussein; Ouzaid, Idir; Pycha, Armin; Comploj, Evi; Svatek, Robert; Lotan, Yair; Karakiewicz, Pierre I.; Holmang, Sten; Shariat, Shahrokh F.

In: Urologic Oncology: Seminars and Original Investigations, 01.01.2017.

Research output: Contribution to journalArticle

Xylinas, Evanguelos ; Kent, Matthew ; Dabi, Yohann ; Rieken, Malte ; Kluth, Luis A. ; Al Awamlh, Bashir Al Hussein ; Ouzaid, Idir ; Pycha, Armin ; Comploj, Evi ; Svatek, Robert ; Lotan, Yair ; Karakiewicz, Pierre I. ; Holmang, Sten ; Shariat, Shahrokh F. / Impact of age on outcomes of patients with non-muscle-invasive bladder cancer treated with immediate postoperative instillation of mitomycin C. In: Urologic Oncology: Seminars and Original Investigations. 2017.
@article{7a74ca9988e14bf18d284b9cf8976112,
title = "Impact of age on outcomes of patients with non-muscle-invasive bladder cancer treated with immediate postoperative instillation of mitomycin C",
abstract = "Objectives: To evaluate whether age affects the clinical benefit afforded by immediate postoperative intravesical instillation of mitomycin C in a contemporary cohort of patients with NMIBC. Patients and methods: A total of 4,258 patients with NMIBC treated with transurethral resection of the bladder with (n = 2,605, 61{\%}) or without (n = 1,652, 39{\%}) one immediate instillation of mitomycin C from 5 institutions (study period: 2000-2007) were included. No patients received adjuvant instillations. A multivariable Cox proportional hazards regression model adjusting for standard clinical and pathological features tested the potential interaction term between age and administration of mitomycin C with regard to disease recurrence. Results: A total of 2,063 patients experienced disease recurrence with a median follow-up of 48 months for those who did not recur. In multivariable Cox regression analysis, immediate postoperative instillation of mitomycin C (HR: 0.62; 95{\%} CI: 0.56-0.68; P<0.0001) and age (HR: 1.04; 95{\%} CI: 1.00-1.09; P = 0.036) were associated with disease recurrence. We observed only slight decreases in recurrence-free survival with age irrespective of treatment administration of mitomycin C or not. Conclusion: We confirmed reduced disease recurrence rates associated with 1 immediate postoperative intravesical instillation of mitomycin C in NMIBC patients. The benefit on recurrence-free survival of a postoperative intravesical instillation was preserved across all ages and therefore age by itself should not be taken into consideration when deciding to use it.",
keywords = "Age, Bladder cancer, Chemotherapy, Elderly, Immediate instillation",
author = "Evanguelos Xylinas and Matthew Kent and Yohann Dabi and Malte Rieken and Kluth, {Luis A.} and {Al Awamlh}, {Bashir Al Hussein} and Idir Ouzaid and Armin Pycha and Evi Comploj and Robert Svatek and Yair Lotan and Karakiewicz, {Pierre I.} and Sten Holmang and Shariat, {Shahrokh F.}",
year = "2017",
month = "1",
day = "1",
doi = "10.1016/j.urolonc.2017.11.010",
language = "English (US)",
journal = "Urologic Oncology: Seminars and Original Investigations",
issn = "1078-1439",
publisher = "Elsevier Inc.",

}

TY - JOUR

T1 - Impact of age on outcomes of patients with non-muscle-invasive bladder cancer treated with immediate postoperative instillation of mitomycin C

AU - Xylinas, Evanguelos

AU - Kent, Matthew

AU - Dabi, Yohann

AU - Rieken, Malte

AU - Kluth, Luis A.

AU - Al Awamlh, Bashir Al Hussein

AU - Ouzaid, Idir

AU - Pycha, Armin

AU - Comploj, Evi

AU - Svatek, Robert

AU - Lotan, Yair

AU - Karakiewicz, Pierre I.

AU - Holmang, Sten

AU - Shariat, Shahrokh F.

PY - 2017/1/1

Y1 - 2017/1/1

N2 - Objectives: To evaluate whether age affects the clinical benefit afforded by immediate postoperative intravesical instillation of mitomycin C in a contemporary cohort of patients with NMIBC. Patients and methods: A total of 4,258 patients with NMIBC treated with transurethral resection of the bladder with (n = 2,605, 61%) or without (n = 1,652, 39%) one immediate instillation of mitomycin C from 5 institutions (study period: 2000-2007) were included. No patients received adjuvant instillations. A multivariable Cox proportional hazards regression model adjusting for standard clinical and pathological features tested the potential interaction term between age and administration of mitomycin C with regard to disease recurrence. Results: A total of 2,063 patients experienced disease recurrence with a median follow-up of 48 months for those who did not recur. In multivariable Cox regression analysis, immediate postoperative instillation of mitomycin C (HR: 0.62; 95% CI: 0.56-0.68; P<0.0001) and age (HR: 1.04; 95% CI: 1.00-1.09; P = 0.036) were associated with disease recurrence. We observed only slight decreases in recurrence-free survival with age irrespective of treatment administration of mitomycin C or not. Conclusion: We confirmed reduced disease recurrence rates associated with 1 immediate postoperative intravesical instillation of mitomycin C in NMIBC patients. The benefit on recurrence-free survival of a postoperative intravesical instillation was preserved across all ages and therefore age by itself should not be taken into consideration when deciding to use it.

AB - Objectives: To evaluate whether age affects the clinical benefit afforded by immediate postoperative intravesical instillation of mitomycin C in a contemporary cohort of patients with NMIBC. Patients and methods: A total of 4,258 patients with NMIBC treated with transurethral resection of the bladder with (n = 2,605, 61%) or without (n = 1,652, 39%) one immediate instillation of mitomycin C from 5 institutions (study period: 2000-2007) were included. No patients received adjuvant instillations. A multivariable Cox proportional hazards regression model adjusting for standard clinical and pathological features tested the potential interaction term between age and administration of mitomycin C with regard to disease recurrence. Results: A total of 2,063 patients experienced disease recurrence with a median follow-up of 48 months for those who did not recur. In multivariable Cox regression analysis, immediate postoperative instillation of mitomycin C (HR: 0.62; 95% CI: 0.56-0.68; P<0.0001) and age (HR: 1.04; 95% CI: 1.00-1.09; P = 0.036) were associated with disease recurrence. We observed only slight decreases in recurrence-free survival with age irrespective of treatment administration of mitomycin C or not. Conclusion: We confirmed reduced disease recurrence rates associated with 1 immediate postoperative intravesical instillation of mitomycin C in NMIBC patients. The benefit on recurrence-free survival of a postoperative intravesical instillation was preserved across all ages and therefore age by itself should not be taken into consideration when deciding to use it.

KW - Age

KW - Bladder cancer

KW - Chemotherapy

KW - Elderly

KW - Immediate instillation

UR - http://www.scopus.com/inward/record.url?scp=85036646519&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85036646519&partnerID=8YFLogxK

U2 - 10.1016/j.urolonc.2017.11.010

DO - 10.1016/j.urolonc.2017.11.010

M3 - Article

C2 - 29221642

AN - SCOPUS:85036646519

JO - Urologic Oncology: Seminars and Original Investigations

JF - Urologic Oncology: Seminars and Original Investigations

SN - 1078-1439

ER -