Survival After Partial Cystectomy Versus Radical Cystectomy for Non-Urothelial Carcinoma of the Bladder: A Population-Based Study

Abstract

Background: The aim of this study was to compare cancer-specific survival (CSS) and overall survival (OS) after partial cystectomy (PC) versus radical cystectomy (RC) in patients with stage T2N0M0 non-urothelial carcinoma of the bladder (NUCB).

Methods: Data on patients with stage T2N0M0 NUCB treated with PC or RC were retrospectively retrieved from the Surveillance, Epidemiology, and End Results (SEER) database from 2007 to 2015. Propensity score matching (PSM) was used to create matched cohorts, which were used to calculate OS and CSS.

Results: Among 999 histologically confirmed NUCB patients (752 in PC group and 247 in RC group), significant differences were found in age, marital status, tumor-related features, and treatment modalities. After 1:1 PSM, 169 pairs were obtained. In the matched cohort, the RC group had significantly higher 1-year, 3-year, and 5-year OS and CSS rates than the PC group (OS: P = 0.002; CSS: P = 0.004). Cox regression analysis showed that older age, unmarried status, and PC were independent risk factors for poor prognosis, while RC was associated with improved survival (OS: hazard ratio (HR) = 0.34, 95% confidence interval (CI): 0.26 - 0.44, P < 0.001; CSS: HR = 0.47, 95% CI: 0.31 - 0.72, P < 0.001). T2b-stage patients had lower cancer-specific mortality than T2a-stage patients (P = 0.01). Subgroup analysis indicated that RC generally led to better survival, except in the neuroendocrine carcinoma subgroup for OS (P = 0.085) and the other carcinoma subgroup for CSS (P = 0.132).

Conclusions: This study reveals that RC is associated with superior CSS and OS compared to PC in patients with NUCB. Patient-related factors (age and marital status) and histological subtype significantly influence prognosis, highlighting the need for personalized treatment strategies.