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- Title
Uitkomsten in de dagelijkse praktijk van eerstelijnschemotherapie voor niet-resectabel stadium III en IV urotheelcarcinoom van de blaas.
- Authors
Reesink, Daan J.; van de Garde, Ewoudt M. W.; van der Nat, Paul B.; Los, Maartje; Horenblas, Simon; van Melick, Harm H. E.; Santeon MIBC-studiegroep; Biesma, D. H.; Stijns, P. E. F.; Lavalaye, J.; de Bruin, P. C.; Peters, B. J. M.; Somford, D. M.; Berends, M.; Richardson, R.; Van Andel, G.; Klaver, O. S.; Haberkorn, B. C. M.; Van Rooijen, J. M.; Korthorst, R. A.
- Abstract
The aim of this study was to evaluate the disparity between the efficacy observed in clinical trials and effectiveness in real-world practice (efficacy-effectiveness gap (EE gap)) in palliative first-line (1L) chemotherapy treatment (CTx) for urothelial carcinoma of the bladder. From seven Dutch teaching hospitals, all patients diagnosed with unresectable stage III (cT2-4aN1-3M0) and IV (cT4b and/or cM1) disease, who received 1L-CTx between 2008 and 2016, were captured. Median overall survival (mOS) of gemcitabine + cisplatin (GemCis)-patients was 10.4 months (95%-CI 7.9–13.0), which was shorter compared to clinical trial findings (range mOS: 12.7–14.3 months) despite comparable clinical characteristics. An EE gap seems present. The mOS of gemcitabine + carboplatin (GemCarbo)-patients was 9.3 months (95%-CI 7.5–11.1). GemCarbo patients had worse prognostic characteristics (higher age, impaired renal function and worse performance status (all p-values < 0.001)) compared to GemCis patients, but survival was not statistically significant different in a multivariable regression analysis (HR 0.90 (95%-CI 0.55–1.47), p-value = 0.674).
- Subjects
OVERALL survival; TRANSITIONAL cell carcinoma; REGRESSION analysis; TEACHING hospitals; CISPLATIN; BLADDER cancer; HEPATORENAL syndrome
- Publication
Tijdschrift voor Urologie, 2024, Vol 14, Issue 4, p74
- ISSN
2211-3037
- Publication type
Article
- DOI
10.1007/s13629-024-00425-5