Introduction: Based on prospective trials’ result, it is unknown whether race/ethnicity affects the magnitude of cancer-specific survival differences after trimodal therapy (TMT) versus external beam radiation therapy alone (EBRT) for urothelial carcinoma for urinary bladder (UCUB). We addressed this knowledge gap. Materials and methods: Within the Surveillance, Epidemiology, and End Results database (2004–2020), we identified patients with cT2-T4aN0M0 UCUB treated with either TMT or EBRT. We focused on the four most prevalent race/ethnicities: Caucasians, Hispanics, African American (AAs) and Asian/Pacific Islanders (APIs). Cumulative incidence plots and multivariable competing risks regression (CRR) models addressed cancer specific mortality (CSM) after additional adjustment for other-cause mortality (OCM) and standard covariates. Results: Of 3249 patients, 2643 (81%) were Caucasians versus 254 (8%) AAs versus 209 (7%) Hispanics versus 143 (4%) APIs. Compared to EBRT, TMT rates were higher in Caucasians (81%) and APIs (81%), lower in AAs (75%) and lowest in Hispanics (69%). In Caucasians, five-year CSM rates were 41.6% after TMT versus 49.0% after EBRT and TMT independently predicted lower CSM (HR: 0.70, p < 0.001). In AAs, Hispanics and APIs, TMT did not predict CSM differences (p = 0.1, 0.2 and p = 0.06, respectively). Conclusion: For Caucasians UCUB patients, TMT is strongly associated with significantly lower CSM. However, this observation cannot be generalized non-Caucasian subgroups, where TMT did not predict lower CSM relative to EBRT.
The effect of race/ethnicity on systemic chemotherapy in urothelial carcinoma patients exposed to radiotherapy / De Angelis, Mario; Siech, Carolin; Di Bello, Francesco; Peñaranda, Natali Rodriguez; Goyal, Jordan A.; Tian, Zhe; Longo, Nicola; Chun, Felix K. H.; Micali, Salvatore; Saad, Fred; Shariat, Shahrokh F.; Jannello, Letizia Maria Ippolita; Longoni, Mattia; Musi, Gennaro; Gandaglia, Giorgio; Moschini, Marco; Montorsi, Francesco; Briganti, Alberto; Karakiewicz, Pierre I.. - In: WORLD JOURNAL OF UROLOGY. - ISSN 1433-8726. - 43:1(2025). [10.1007/s00345-025-05767-2]
The effect of race/ethnicity on systemic chemotherapy in urothelial carcinoma patients exposed to radiotherapy
Di Bello, Francesco;Longo, Nicola;Musi, Gennaro;
2025
Abstract
Introduction: Based on prospective trials’ result, it is unknown whether race/ethnicity affects the magnitude of cancer-specific survival differences after trimodal therapy (TMT) versus external beam radiation therapy alone (EBRT) for urothelial carcinoma for urinary bladder (UCUB). We addressed this knowledge gap. Materials and methods: Within the Surveillance, Epidemiology, and End Results database (2004–2020), we identified patients with cT2-T4aN0M0 UCUB treated with either TMT or EBRT. We focused on the four most prevalent race/ethnicities: Caucasians, Hispanics, African American (AAs) and Asian/Pacific Islanders (APIs). Cumulative incidence plots and multivariable competing risks regression (CRR) models addressed cancer specific mortality (CSM) after additional adjustment for other-cause mortality (OCM) and standard covariates. Results: Of 3249 patients, 2643 (81%) were Caucasians versus 254 (8%) AAs versus 209 (7%) Hispanics versus 143 (4%) APIs. Compared to EBRT, TMT rates were higher in Caucasians (81%) and APIs (81%), lower in AAs (75%) and lowest in Hispanics (69%). In Caucasians, five-year CSM rates were 41.6% after TMT versus 49.0% after EBRT and TMT independently predicted lower CSM (HR: 0.70, p < 0.001). In AAs, Hispanics and APIs, TMT did not predict CSM differences (p = 0.1, 0.2 and p = 0.06, respectively). Conclusion: For Caucasians UCUB patients, TMT is strongly associated with significantly lower CSM. However, this observation cannot be generalized non-Caucasian subgroups, where TMT did not predict lower CSM relative to EBRT.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
