Cystectomy in Metastatic Bladder Cancer: Feasibility, Safety and Outcomes.

Area of Science:

• Oncology
• Surgical Oncology
• Urology

Background:

• Metastatic bladder cancer (mBCa) treatment efficacy via cystectomy is understudied.
• Local treatment may alleviate symptoms, improve quality of life (QoL), and reduce systemic therapy adverse events in mBCa.
• Investigating cystectomy's safety and efficacy in mBCa is crucial for patient outcomes.

Purpose of the Study:

• To evaluate the safety and efficacy of cystectomy in patients with metastatic bladder cancer (mBCa).
• To assess the impact of cystectomy on patient survival, quality of life (QoL), and eligibility for systemic therapy.
• To determine the oncological benefits of cystectomy in advanced bladder cancer.

Main Methods:

• Retrospective analysis of 524 bladder cancer patients from 2008-2019.
• Focused on a cohort of 21 mBCa patients with resectable tumors undergoing cystectomy.
• Evaluated pre/postoperative status, metastatic burden, surgical complications (Clavien-Dindo), systemic therapy benefits, and survival.

Main Results:

• No severe intraoperative complications; 2 patients had Clavien Grade III postoperative events.
• 11 of 21 patients survived 1 year post-surgery; 19 were eligible for first-line chemotherapy.
• Quality of life (QoL) improved post-surgery; 13 patients proceeded to second-line chemotherapy with manageable adverse events.

Conclusions:

• Cystectomy in mBCa primarily benefits patients through improved QoL and reduced contraindications for systemic therapy.
• Cystectomy may decrease adverse events during chemotherapy, warranting consideration in advanced bladder cancer treatment.
• The study highlights cystectomy as a valuable option for select mBCa patients, improving overall treatment experience and outcomes.