Surgery Remains Best Option for Rare Bladder Cancer

09/28/2018

In a recent paper published in the World Journal of Urology, Saint Louis University researchers reviewed data for patients with a rare type of bladder cancer, examining the treatments they received and the subsequent five-year-survival rates. 

Zachary Hamilton, M.D., assistant professor of urologic surgery at SLU and a SLUCare urologic oncologist, reports that surgery for invasive non-urachal adenocarcinoma (ACB), led to the best survival rates.

“Our data analysis shows improved survival outcomes for patients undergoing definitive surgical extirpation, the removal of cancerous tissue or organs, compared to other treatments,” Hamilton said. “Surgery remains the mainstay of treatment with this kind of cancer.”

The researchers reviewed data from the National Cancer Database (NCDB), a joint project of the Commission on Cancer of the American College of Surgeons and the American Cancer Society. The NCDB includes data from all cancer patients treated at participating institutions and is estimated to capture over 70 percent of new cancer cases in the U.S.

Hamilton and his colleagues examined records for patients treated for invasive non-urachal adenocarcinoma, a rare malignancy found in between .05 to 2 percent of patients diagnosed with bladder cancer, from 2004 to 2015.

The team looked at 851 patient records and found that 398 received no treatment, 298 received cystecotomy, a surgery to remove the urinary bladder, 124 received external beam radiation therapy (EBRT) and 31 received EBRT plus cystectomy.

The five-year survival rate was significantly better for patients who underwent cystectomy alone. In fact, it was the only treatment that was associated with improved survival. The study concluded that surgery is underutilized for invasive ACB, and that bladder preservation with radiation therapy has no survival benefit.

Other researchers on the study include Facundo Davaro, M.D., Jared Schaefer, B.S., Allison May, M.D., Johar Syed Raza, M.D., and Sameer Siddiqui, M.D. The digital object identifier is: https://doi.org/10.1007/s00345-018-2411-7

Established in 1836, Saint Louis University School of Medicine has the distinction of awarding the first medical degree west of the Mississippi River. The school educates physicians and biomedical scientists, conducts medical research, and provides health care on a local, national and international level. Research at the school seeks new cures and treatments in five key areas: cancer, liver disease, heart/lung disease, aging and brain disease, and infectious diseases.