KEY TAKEAWAYS
- The study aimed to compare oncological outcomes and quality of life between pelvic organ-preserving and SRC in women with bladder cancer.
- Researchers noticed that stricter criteria and additional evidence are needed for POPRC to ensure optimal oncological outcomes.
Pelvic organ-preserving radical cystectomy (POPRC) has been reported to result in a better postoperative quality of life in females with bladder cancer compared to standard radical cystectomy (SRC). However, its oncological outcomes remain a concern.
Chuanlin Wang and the team aimed to assess the comparative oncological outcomes and quality of life between POPRC and SRC in female bladder cancer patients, addressing the need for more robust evidence to validate the benefits of POPRC in terms of both survival and patient well-being.
They performed an inclusive analysis using data from the Surveillance, Epidemiology, and End Results (SEER) database to identify female bladder cancer patients who underwent either POPRC or SRC. Logistic regression was employed to identify predictors of POPRC usage.
To mitigate the impact of baseline differences on survival outcomes, a 1:2 propensity score matching (PSM) was applied. Kaplan-Meier curves and Log-rank tests were then utilized to assess the significance of overall survival (OS) differences between SRC and POPRC groups. Additionally, subgroup analysis based on predetermined indicators was conducted.
About 2,193 patients were included with a median follow-up of 53 months, of whom 233 (10.6%) received POPRC and 1,960 (89.4%) received SRC. No definitive predictors of POPRC were identified. Before PSM, POPRC resulted in a comparable OS to SRC (HR = 1.09, P = 0.309).
However, after PSM, POPRC was associated with significantly worse OS (HR = 1.23, P = 0.038). In subgroup analyses, POPRC showed non-inferior OS in patients with non-muscle invasive bladder cancer (NMIBC) (HR = 1.18, 95%CI 0.71-1.95, P = 0.531) and T2 patients (HR = 1.07, P = 0.669), but significantly worse OS in T3 patients (HR = 1.41, P = 0.02).
The study concluded that while POPRC currently does not involve strict screening, candidates for POPRC should be subject to more stringent criteria in the future to ensure satisfactory oncological outcomes. However, due to flaws in the study, additional evidence is needed to support these findings.
The study received no funds.
Source: https://pubmed.ncbi.nlm.nih.gov/39182105/
Wang C, Zhang X. (2024). “Pelvic organ-preserving radical cystectomy versus standard radical cystectomy in female patients diagnosed with bladder cancer.” World J Surg Oncol. 2024;22(1):218. Published 2024 Aug 24. doi:10.1186/s12957-024-03502-6
