Conditional survival of patients treated with first-line chemotherapy for metastatic urothelial cancer

Clin Genitourin Cancer. 2015 Jun;13(3):244-9. doi: 10.1016/j.clgc.2014.10.003. Epub 2014 Oct 24.

Abstract

Background: Measures of prognosis for cancer patients are typically evaluated at the time of diagnosis. However, this study assessed the changes in 2-year CS rates after first-line chemotherapy for metastatic UC.

Patients and methods: Conditional overall survival and CPFS probability were estimated using the Kaplan-Meier method. Adjusted survival functions were stratified according to age groups (< 70 years vs. ≥ 70 years), sex, Eastern Cooperative Oncology Group (ECOG) performance status (PS; ECOG PS ≤ 2 vs. ECOG PS > 2), pretreatment Hb levels (< 12 mg/dL vs. ≥ 12 mg/dL) and pretreatment NLR (< 3 vs. ≥ 3). Pairs of CS curves were compared using the Mantel-Haenszel log-rank test.

Results: Two hundred ninety-eight patients were included in this analysis, 233 were male, and their median age was 69 years. First-line median overall survival and progression-free survival were 10.7 months (95% confidence interval [CI], 9.6-12.6) and 6.0 months (95% CI, 5.5-7.1), respectively. CPFS and COS showed an increasing trend in the population considered (b = 0.35; P < .001 and b = 0.79; P < .001, respectively). A significant increase in terms of COS and CPFS trends was identified in patients with age < 70 years (P = .02 and P = .005, respectively) and pretreatment NLR ≤ 3 (P = .05 and P < .001, respectively). Patients with Hb levels < 12 g/dL showed a significantly poorer 2-year COS.

Conclusion: The conditional probability of survival at 2 years from the start of first-line chemotherapy for advanced UC changes over time according to clinical characteristics.

Keywords: Advanced urothelial cancer; Conditional Survival; Overall survival; Prognosis; Progression-free survival.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Antineoplastic Agents / therapeutic use*
  • Female
  • Hemoglobins / metabolism
  • Humans
  • Male
  • Middle Aged
  • Neoplasm Metastasis
  • Prognosis
  • Retrospective Studies
  • Survival Analysis
  • Treatment Outcome
  • Urologic Neoplasms / blood
  • Urologic Neoplasms / drug therapy*
  • Urologic Neoplasms / mortality*
  • Urologic Neoplasms / pathology
  • Urothelium / drug effects
  • Urothelium / pathology*

Substances

  • Antineoplastic Agents
  • Hemoglobins