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Conservative management and female gender are associated with increased cancer‐specific death in patients with isolated primary urothelial carcinoma in situ
Author(s) -
Alanee S.,
Bauman J.,
Dynda D.,
Frye T.,
Konety B.,
Schwartz B.
Publication year - 2015
Publication title -
european journal of cancer care
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.849
H-Index - 67
eISSN - 1365-2354
pISSN - 0961-5423
DOI - 10.1111/ecc.12217
Subject(s) - medicine , hazard ratio , proportional hazards model , cohort , conservative management , multivariate analysis , epidemiology , retrospective cohort study , urothelial carcinoma , cancer , disease , gynecology , surgery , bladder cancer , confidence interval
Our goal was to investigate the effect of patient and disease characteristics on the probability of cancer‐specific death ( CSD ) in cases of isolated urothelial carcinoma in situ ( CIS ). We performed a retrospective analysis of patients diagnosed with isolated CIS between 1990 and 2010 identified from the S urveillance, E pidemiology, and E nd R esults ( SEER ) database. Competing risk analysis using C ox proportional hazard model was used to examine the probability of CSD controlling for possible covariates. Overall ( n = 1432), patients were mainly male (75%), mean age at diagnosis was 71 years, median survival 47 months, and 65% of the patients had CIS in their upper urinary tract. Caucasians were the predominant race (90%). CIS was the cause of death in 87/1432(6%) of the total cohort; 69/1239 (6%) of patients who underwent surgery, and 18/193 (9%) of the patients who were managed conservatively ( CM ). On multivariate analysis, CM [hazard ration ( HR ) = 2.019, CI : 1.189–3.429, P = 0.009] and female gender ( HR = 1.690, CI : 1.041–2.741, P = 0.033) were associated with CSD , while age, site, race and year of diagnosis were non‐significant predictors. Female gender and conservative management were positively associated with CSD . Multi‐institutional collaboration is needed to validate markers for poor prognosis in cases of isolated CIS .