Does radical cystectomy have a better prognosis than bladder conservative treatment in the real world?

Author:

Nakagawa Ryunosuke1ORCID,Izumi Kouji1,Toriumi Ren1,Aoyama Shuhei1,Kamijima Taiki1,Makino Tomoyuki1ORCID,Naito Renato1,Iwamoto Hiroaki1ORCID,Yaegashi Hiroshi1ORCID,Kawaguchi Shohei1ORCID,Shigehara Kazuyoshi1ORCID,Nohara Takahiro1ORCID,Mizokami Atsushi1

Affiliation:

1. Department of Integrative Cancer Therapy and Urology Kanazawa University Graduate School of Medical Science Kanazawa Japan

Abstract

PurposeTo compare the prognosis and quality of life between radical cystectomy and bladder conservative treatment for muscle invasive bladder cancer in the real world.Materials and MethodsPatients treated for muscle invasive bladder cancer without metastases were retrospectively evaluated for overall survival, progression‐free survival, and rehospitalization.ResultsOf the 141 patients, 62 underwent bladder conservative treatment and 79 underwent radical cystectomy. Patients who underwent radical cystectomy had significantly better progression‐free survival (HR: 1.83, 95% CI: 1.12–3.00; p < 0.01) and overall survival (HR: 1.82, 95% CI: 0.99–3.34; p = 0.03) than those who underwent conservative treatment. However, there was no significant difference in prognosis between patients who refused to undergo radical cystectomy and those who underwent. In addition, rehospitalization rates for complications and additional treatment were significantly higher in patients who received conservative treatment (69.3% vs. 34.2%; p < 0.01), and the length of hospital stay was also prolonged compared to patients who received radical cystectomy (26 vs. 9 days; p = 0.03).ConclusionsOverall, conservative treatment had a significantly poorer prognosis than radical cystectomy, but there was no significant difference in prognosis when comparing patients who refused radical cystectomy and received conservative treatment with those who received radical cystectomy. However, hospitalization rates and length of stay were significantly worse for patients who chose conservative treatment, which may lead to a decline in quality of life.

Publisher

Wiley

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