Conditional survival of patients treated with first-line chemotherapy for metastatic urothelial cancer

Abstract Background Measures of prognosis for cancer patients are typically evaluated at the time of diagnosis. However, this study assessed the changes in 2-year CS rates after first-line chemotherapy for metastatic UC. Patients and Methods Conditional overall survival and CPFS probability were estimated using the Kaplan-Meier method. Adjusted survival functions were stratified according to age groups (< 70 years vs. ≥ 70 years), sex, Eastern Cooperative Oncology Group (ECOG) performance status (PS; ECOG PSA ≤ 2 vs. ECOG PS > 2), pretreatment Hb levels (< 12 mg/dL vs. ≥ 12 mg/dL) and pretreatment NLR (< 3 vs. ≥ 3). Pairs of CS curves were compared using the Mantel-Haenszel log-rank test. Results Two hundred ninety-eight patients were included in this analysis, 233 were male, and their median age was 69 years. First-line median overall survival and progression-free survival were 10.7 months (95% confidence interval [CI], 9.6-12.6) and 6.0 months (95% CI, 5.5-7.1), respectively. CPFS and COS showed an increasing trend in the population considered (b = 0.35; P <.001 and b = 0.79; P <.001, respectively). A significant increase in terms of COS and CPFS trends was identified in patients with age < 70 years (P =.02 and P =.005, respectively) and pretreatment NLR ≤ 3 (P =.05 and P <.001, respectively). Patients with Hb levels < 12 g/dL showed a significantly poorer 2-year COS. Conclusion The conditional probability of survival at 2 years from the start of first-line chemotherapy for advanced UC changes over time according to clinical characteristics.