Trimodality therapy (TMT) is a standard treatment option for select patients with muscle-invasive bladder cancer. The efficacy of TMT has been shown in several randomized trials; however, the long-term effect on renal function has not yet been investigated. Furthermore, various types of chemotherapy agents (ie. mitomycin, 5-FU, cisplatin) used during TMT are known to be nephrotoxic. As many bladder cancer patients are elderly with significant medical comorbidities, data on long-term renal function would aid in selecting the appropriate management. We sought to evaluate the change in renal function over 10 years in bladder cancer patients who have completed TMT
Massachusetts General Hospital’s institutional TMT database was retrospectively reviewed to obtain eGFR values to quantify renal function at initial time of muscle-invasive bladder cancer diagnosis. The eGFR values were calculated using the CKD-EPI creatinine equation. These eGFR values collected at time of muscle invasive bladder cancer and prior to initiation of TMT were considered the baseline eGFR. Interval eGFR were obtained for years 1, 3, 5, and 10 after the date of bladder cancer diagnosis.
287 patients undergoing TMT treatment for muscle invasive bladder cancer were reviewed. Patients were excluded due to incomplete TMT treatment or missing data resulting in 251 eligible patients for evaluation of baseline mean eGFR. Median follow up was 4.56 years. Baseline mean eGFR was 65.67 mL/min/1.73. Mean eGFR for years 1, 3, 5, and 10 were 58.43 mL/min/1.73, 55.4 mL/min/1.73, 54.54 mL/min/1.73, and 57.3 mL/min/1.73, respectively.
Renal function for bladder cancer patients undergoing TMT declined slightly after 1 year of follow up but remained stable for the remainder of the 10 years of follow up. Further studies are needed to identify predictors of renal decline and compare these results with radical cystectomy cohorts and the general population.
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Long Term Renal Function Outcomes in Trimodality Therapy for Bladder Cancer
Bladder Cancer > Muscle Invasive Bladder Cancer
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Wednesday, November 30
1:00 p.m. - 2:00 p.m.
Presented By: Linda V. Nguyen
Linda V. Nguyen
Alexandra E. Hunter
William U. Shipley
Niall M. Heney
Anthony L. Zietman
Matthew F. Wszolek
Adam S. Feldman