Introduction

Bladder cancer is the ninth most commonly diagnosed cancer worldwide, with more than 300,000 new cases per year, and it causes around 150,000 deaths every year. Despite these figures, there is scarce data in the literature on the prognosis of patients with muscle invasive bladder cancer (MIBC) who are unfit for curative treatment. Our aim is to find out the survival of patients diagnosed with MIBC who were not suitable for treatment with curative intent in our center. We also analyze variables associated with survival, as well as the number of visits to the emergency room and palliative procedures needed.

Methods

Retrospective analysis of a cohort of patients with histopathologic diagnosis of MIBC dismissed for treatment with curative intent (cystectomy, radiotherapy and/or chemotherapy), between January 2007 and December 2012. We analyzed overall survival (OS) and cancer-specific survival (CSS), as well as their relationship with demographic (age, gender) and clinical/pathological variables (comorbidities, tumor stage, reason for dismissing curative treatment and urinary tract obstruction at diagnosis). We also evaluated the number of visits to the emergency room due to bladder cancer and palliative procedures needed: hemostatic transurethral resection (TUR), radiotherapy or nephrostomy catheter.

Results

We included 110 patients (96 males/14 females), with a mean age of 79. Regarding American Society of Anesthesiologists (ASA) risk, 67.3% of them were ASA III or higher; 63.6% presented with localized stage and 21.8% with metastases at diagnosis. Around half of our patients (50.9%) had urinary tract obstruction at diagnosis. The main causes to dismiss treatment with curative intent were comorbidities (39.1%) and advanced stage (36.4%). OS at 1 and 2 years was 30% and 14% respectively, with a median OS of 7.17 months. CSS at 1 and 2 years was 50% and 28% respectively, with a median CSS of 12.1 months. Variables associated with a worse survival were advanced clinical stage and urinary tract obstruction. Patients attended the emergency room a mean of 2.85 times due to their cancer. In our series, 18.2% of the patients underwent hemostatic TUR, whilst 10% needed hemostatic radiotherapy and nephrostomy catheters were placed in 24.5% of them.

Conclusions

In our series we find out an OS under 2 years in most of the patients, with a median OS under 1 year. Factors associated with worse prognosis were the presence of urinary tract obstruction at diagnosis and advanced clinical stage.

Funding

None.