Real-World Outcomes After Radical Cystectomy for Muscle-Invasive Bladder Cancer in Japan: A Nationwide Descriptive
Shingo Hatakeyama1,2, Kyoko Yamamoto3, Hiroyuki Yamamoto1,3
1National Clinical Database Steering Committee of Japanese Urological Association, Tokyo, Japan.
Summary
Real-world survival after radical cystectomy for muscle-invasive bladder cancer in Japan varies by age and treatment. Older patients and those not receiving neoadjuvant chemotherapy had poorer outcomes, with open surgery showing less favorable results.
Area of Science:
- Urology
- Oncology
- Public Health
Background:
- Muscle-invasive bladder cancer (MIBC) necessitates radical cystectomy (RC).
- Understanding real-world survival outcomes in Japan is crucial for treatment optimization.
- Nationwide data provides a robust platform for analyzing survival trends.
Purpose of the Study:
- To evaluate disease-free survival (DFS) and overall survival (OS) post-RC for MIBC in Japan.
- To describe patient demographics, treatment patterns, and survival outcomes using national data.
- To identify factors associated with survival in a real-world setting.
Main Methods:
- A nationwide descriptive study utilizing data from the National Clinical Database (NCD) in 2020.
- Inclusion of patients with MIBC who underwent RC.
- Kaplan-Meier method for DFS and OS estimation; descriptive comparisons across subgroups.
Main Results:
- 3773 patients analyzed, with 41% aged 75 years or older.
- Robotic-assisted RC was prevalent (44%); 52% received neoadjuvant chemotherapy (NAC).
- Survival decreased with age; older patients (≥80 years) had the worst outcomes. Female sex, no NAC, and open RC were linked to lower survival.
Conclusions:
- This study offers a comprehensive overview of real-world survival after RC for MIBC in Japan.
- Significant heterogeneity exists in patient characteristics, treatments, and outcomes.
- Findings lay the groundwork for future risk-adjusted analyses and clinical hypothesis generation.
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