247P - Adjuvant chemoradiotherapy in the management of bladder adenocarcinoma compared to multiple treatment modalities

Background

Adenocarcinoma is an uncommon histologic variant and accounts for 0.5-2% of bladder cancers in the United States. Due to its rarity, there is limited data in the literature specifically focused on bladder adenocarcinoma treatment. So, the aim of this study is focused on evaluating the impact of chemoradiotherapy compared to multiple treatment modalities on the survival of patients with primary bladder adenocarcinoma.

Methods

The Surveillance, Epidemiology, and End Results (SEER) Program 17 registries database was utilized to identify primary bladder adenocarcinoma cases from (2000-2020). The disease stages and sociodemographic data were collected. The patients were subgrouped according to the treatment modality: primary chemotherapy, surgery only, adjuvant chemotherapy, adjuvant radiotherapy, and adjuvant chemoradiotherapy. SPSS Version 23 was used for data analysis. log-rank Kaplan-Meir curve was used for survival analysis.

Results

A total of 2500 cases of bladder adenocarcinoma were identified. Overall, the 5-year relative survival was 43.1%. With multiple treatment options, we found surgery with no systemic therapy had a better survival outcome (47.4%) compared to adjuvant chemotherapy (38%), adjuvant chemoradiotherapy (31.4), adjuvant radiotherapy (21.5%), and least primary chemotherapy (4.9%) (P <0.001). In the group that had surgical management with no systemic therapy, the localized stage had significantly improved survival compared to the regional and distant spread (62%, 40%, and 10.8%, respectively; P <0.001).

Conclusions

This study provides a comprehensive evaluation of multiple treatment modalities, and the results highlight surgery with no systemic therapy as the modality of choice for improved survival outcome. This eliminates the burden of adjuvant therapy with unfavorable side effects. However, few selected patients may use chemo(radio)therapy with special considerations.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

The authors.

Funding

Has not received any funding.

Disclosure

All authors have declared no conflicts of interest.