Disease-free survival at 2 or 3 years correlates with 5-year overall survival of patients undergoing radical cystectomy for muscle invasive bladder cancer

Guru Sonpavde, Myrna M. Khan, Seth P. Lerner, Robert S. Svatek, Giacomo Novara, Pierre I. Karakiewicz, Eila Skinner, Derya Tilki, Wassim Kassouf, Yves Fradet, Colin P. Dinney, Hans Martin Fritsche, Jonathan I. Izawa, Patrick J. Bastian, Vincenzo Ficarra, Mark P. Schoenberg, Arthur I. Sagalowsky, Yair Lotan, Shahrokh F. Shariat

Research output: Contribution to journalArticle

50 Citations (Scopus)

Abstract

Purpose The conventional primary end point in trials of perioperative systemic therapy for muscle invasive bladder cancer is 5-year overall survival. We identified an association between disease-free survival at 2 to 3 years and 5-year overall survival. Materials and Methods We retrospectively analyzed a multicenter database containing records of 2,724 patients treated with radical cystectomy for muscle invasive bladder cancer with negative margins. Of these patients 844 had received adjuvant chemotherapy. We evaluated the association of disease-free survival at 2 and 3 years with overall survival at 5 years using Cox proportional hazards modeling and the kappa statistic. Results Overall 2-year/3-year disease-free survival was 0.63/0.57 and 5-year overall survival was 0.47. The overall agreement between 2-year disease-free survival and 5-year overall survival was 79%, and between 3-year disease-free survival and 5-year overall survival was 81%. Agreements were similar when analyzed within pathological substages, radical cystectomy decades and adjuvant chemotherapy subgroups. The kappa statistic was 0.57 (95% CI 0.530.60) for 2-year disease-free survival/5-year overall survival and 0.61 (95% CI 0.580.64) for 3-year disease-free survival/5-year overall survival, indicating moderate agreement. The hazard ratio for disease-free survival as a time dependent variable was 12.7 (95% CI 11.6013.90), indicating a strong relationship between disease-free and overall survival. Conclusions Disease-free survival rates at 2 and 3 years correlate with and are potential intermediate surrogates for 5-year overall survival in patients treated with radical cystectomy for muscle invasive bladder cancer regardless of adjuvant chemotherapy. These data warrant external validation and may expedite the development of adjuvant systemic therapy. In addition, they may be applicable to the neoadjuvant setting.

Original languageEnglish (US)
Pages (from-to)456-461
Number of pages6
JournalJournal of Urology
Volume185
Issue number2
DOIs
StatePublished - Feb 2011
Externally publishedYes

Fingerprint

Cystectomy
Urinary Bladder Neoplasms
Disease-Free Survival
Muscles
Survival
Adjuvant Chemotherapy
Survival Rate
Databases

Keywords

  • cystectomy
  • disease-free survival
  • urinary bladder neoplasms

ASJC Scopus subject areas

  • Urology

Cite this

Disease-free survival at 2 or 3 years correlates with 5-year overall survival of patients undergoing radical cystectomy for muscle invasive bladder cancer. / Sonpavde, Guru; Khan, Myrna M.; Lerner, Seth P.; Svatek, Robert S.; Novara, Giacomo; Karakiewicz, Pierre I.; Skinner, Eila; Tilki, Derya; Kassouf, Wassim; Fradet, Yves; Dinney, Colin P.; Fritsche, Hans Martin; Izawa, Jonathan I.; Bastian, Patrick J.; Ficarra, Vincenzo; Schoenberg, Mark P.; Sagalowsky, Arthur I.; Lotan, Yair; Shariat, Shahrokh F.

In: Journal of Urology, Vol. 185, No. 2, 02.2011, p. 456-461.

Research output: Contribution to journalArticle

Sonpavde, G, Khan, MM, Lerner, SP, Svatek, RS, Novara, G, Karakiewicz, PI, Skinner, E, Tilki, D, Kassouf, W, Fradet, Y, Dinney, CP, Fritsche, HM, Izawa, JI, Bastian, PJ, Ficarra, V, Schoenberg, MP, Sagalowsky, AI, Lotan, Y & Shariat, SF 2011, 'Disease-free survival at 2 or 3 years correlates with 5-year overall survival of patients undergoing radical cystectomy for muscle invasive bladder cancer', Journal of Urology, vol. 185, no. 2, pp. 456-461. https://doi.org/10.1016/j.juro.2010.09.110
Sonpavde, Guru ; Khan, Myrna M. ; Lerner, Seth P. ; Svatek, Robert S. ; Novara, Giacomo ; Karakiewicz, Pierre I. ; Skinner, Eila ; Tilki, Derya ; Kassouf, Wassim ; Fradet, Yves ; Dinney, Colin P. ; Fritsche, Hans Martin ; Izawa, Jonathan I. ; Bastian, Patrick J. ; Ficarra, Vincenzo ; Schoenberg, Mark P. ; Sagalowsky, Arthur I. ; Lotan, Yair ; Shariat, Shahrokh F. / Disease-free survival at 2 or 3 years correlates with 5-year overall survival of patients undergoing radical cystectomy for muscle invasive bladder cancer. In: Journal of Urology. 2011 ; Vol. 185, No. 2. pp. 456-461.
@article{d074e9a8303543498e94e326778aab9a,
title = "Disease-free survival at 2 or 3 years correlates with 5-year overall survival of patients undergoing radical cystectomy for muscle invasive bladder cancer",
abstract = "Purpose The conventional primary end point in trials of perioperative systemic therapy for muscle invasive bladder cancer is 5-year overall survival. We identified an association between disease-free survival at 2 to 3 years and 5-year overall survival. Materials and Methods We retrospectively analyzed a multicenter database containing records of 2,724 patients treated with radical cystectomy for muscle invasive bladder cancer with negative margins. Of these patients 844 had received adjuvant chemotherapy. We evaluated the association of disease-free survival at 2 and 3 years with overall survival at 5 years using Cox proportional hazards modeling and the kappa statistic. Results Overall 2-year/3-year disease-free survival was 0.63/0.57 and 5-year overall survival was 0.47. The overall agreement between 2-year disease-free survival and 5-year overall survival was 79{\%}, and between 3-year disease-free survival and 5-year overall survival was 81{\%}. Agreements were similar when analyzed within pathological substages, radical cystectomy decades and adjuvant chemotherapy subgroups. The kappa statistic was 0.57 (95{\%} CI 0.530.60) for 2-year disease-free survival/5-year overall survival and 0.61 (95{\%} CI 0.580.64) for 3-year disease-free survival/5-year overall survival, indicating moderate agreement. The hazard ratio for disease-free survival as a time dependent variable was 12.7 (95{\%} CI 11.6013.90), indicating a strong relationship between disease-free and overall survival. Conclusions Disease-free survival rates at 2 and 3 years correlate with and are potential intermediate surrogates for 5-year overall survival in patients treated with radical cystectomy for muscle invasive bladder cancer regardless of adjuvant chemotherapy. These data warrant external validation and may expedite the development of adjuvant systemic therapy. In addition, they may be applicable to the neoadjuvant setting.",
keywords = "cystectomy, disease-free survival, urinary bladder neoplasms",
author = "Guru Sonpavde and Khan, {Myrna M.} and Lerner, {Seth P.} and Svatek, {Robert S.} and Giacomo Novara and Karakiewicz, {Pierre I.} and Eila Skinner and Derya Tilki and Wassim Kassouf and Yves Fradet and Dinney, {Colin P.} and Fritsche, {Hans Martin} and Izawa, {Jonathan I.} and Bastian, {Patrick J.} and Vincenzo Ficarra and Schoenberg, {Mark P.} and Sagalowsky, {Arthur I.} and Yair Lotan and Shariat, {Shahrokh F.}",
year = "2011",
month = "2",
doi = "10.1016/j.juro.2010.09.110",
language = "English (US)",
volume = "185",
pages = "456--461",
journal = "Journal of Urology",
issn = "0022-5347",
publisher = "Elsevier Inc.",
number = "2",

}

TY - JOUR

T1 - Disease-free survival at 2 or 3 years correlates with 5-year overall survival of patients undergoing radical cystectomy for muscle invasive bladder cancer

AU - Sonpavde, Guru

AU - Khan, Myrna M.

AU - Lerner, Seth P.

AU - Svatek, Robert S.

AU - Novara, Giacomo

AU - Karakiewicz, Pierre I.

AU - Skinner, Eila

AU - Tilki, Derya

AU - Kassouf, Wassim

AU - Fradet, Yves

AU - Dinney, Colin P.

AU - Fritsche, Hans Martin

AU - Izawa, Jonathan I.

AU - Bastian, Patrick J.

AU - Ficarra, Vincenzo

AU - Schoenberg, Mark P.

AU - Sagalowsky, Arthur I.

AU - Lotan, Yair

AU - Shariat, Shahrokh F.

PY - 2011/2

Y1 - 2011/2

N2 - Purpose The conventional primary end point in trials of perioperative systemic therapy for muscle invasive bladder cancer is 5-year overall survival. We identified an association between disease-free survival at 2 to 3 years and 5-year overall survival. Materials and Methods We retrospectively analyzed a multicenter database containing records of 2,724 patients treated with radical cystectomy for muscle invasive bladder cancer with negative margins. Of these patients 844 had received adjuvant chemotherapy. We evaluated the association of disease-free survival at 2 and 3 years with overall survival at 5 years using Cox proportional hazards modeling and the kappa statistic. Results Overall 2-year/3-year disease-free survival was 0.63/0.57 and 5-year overall survival was 0.47. The overall agreement between 2-year disease-free survival and 5-year overall survival was 79%, and between 3-year disease-free survival and 5-year overall survival was 81%. Agreements were similar when analyzed within pathological substages, radical cystectomy decades and adjuvant chemotherapy subgroups. The kappa statistic was 0.57 (95% CI 0.530.60) for 2-year disease-free survival/5-year overall survival and 0.61 (95% CI 0.580.64) for 3-year disease-free survival/5-year overall survival, indicating moderate agreement. The hazard ratio for disease-free survival as a time dependent variable was 12.7 (95% CI 11.6013.90), indicating a strong relationship between disease-free and overall survival. Conclusions Disease-free survival rates at 2 and 3 years correlate with and are potential intermediate surrogates for 5-year overall survival in patients treated with radical cystectomy for muscle invasive bladder cancer regardless of adjuvant chemotherapy. These data warrant external validation and may expedite the development of adjuvant systemic therapy. In addition, they may be applicable to the neoadjuvant setting.

AB - Purpose The conventional primary end point in trials of perioperative systemic therapy for muscle invasive bladder cancer is 5-year overall survival. We identified an association between disease-free survival at 2 to 3 years and 5-year overall survival. Materials and Methods We retrospectively analyzed a multicenter database containing records of 2,724 patients treated with radical cystectomy for muscle invasive bladder cancer with negative margins. Of these patients 844 had received adjuvant chemotherapy. We evaluated the association of disease-free survival at 2 and 3 years with overall survival at 5 years using Cox proportional hazards modeling and the kappa statistic. Results Overall 2-year/3-year disease-free survival was 0.63/0.57 and 5-year overall survival was 0.47. The overall agreement between 2-year disease-free survival and 5-year overall survival was 79%, and between 3-year disease-free survival and 5-year overall survival was 81%. Agreements were similar when analyzed within pathological substages, radical cystectomy decades and adjuvant chemotherapy subgroups. The kappa statistic was 0.57 (95% CI 0.530.60) for 2-year disease-free survival/5-year overall survival and 0.61 (95% CI 0.580.64) for 3-year disease-free survival/5-year overall survival, indicating moderate agreement. The hazard ratio for disease-free survival as a time dependent variable was 12.7 (95% CI 11.6013.90), indicating a strong relationship between disease-free and overall survival. Conclusions Disease-free survival rates at 2 and 3 years correlate with and are potential intermediate surrogates for 5-year overall survival in patients treated with radical cystectomy for muscle invasive bladder cancer regardless of adjuvant chemotherapy. These data warrant external validation and may expedite the development of adjuvant systemic therapy. In addition, they may be applicable to the neoadjuvant setting.

KW - cystectomy

KW - disease-free survival

KW - urinary bladder neoplasms

UR - http://www.scopus.com/inward/record.url?scp=78651295543&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=78651295543&partnerID=8YFLogxK

U2 - 10.1016/j.juro.2010.09.110

DO - 10.1016/j.juro.2010.09.110

M3 - Article

C2 - 21167527

AN - SCOPUS:78651295543

VL - 185

SP - 456

EP - 461

JO - Journal of Urology

JF - Journal of Urology

SN - 0022-5347

IS - 2

ER -