{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T02:35:35Z","timestamp":1791599735884,"version":"4.3.4"},"reference-count":31,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2024,2,6]],"date-time":"2024-02-06T00:00:00Z","timestamp":1707177600000},"content-version":"vor","delay-in-days":36,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer Medicine"],"published-print":{"date-parts":[[2024,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Bladder preservation therapy is an alternative to radical cystectomy in patients with muscle\u2010invasive bladder cancer (MIBC). The purpose of this study is to compare survival outcomes between bladder preservation therapy and radical cystectomy in MIBC patients using an Asian nationwide cancer registry database.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>From the Taiwan Cancer Registry database and the Taiwan National Health Insurance Research Database, we identified bladder cancer patients from 2008 to 2018. The patients with urothelial carcinoma and clinical stage T2\u2010T4aN0\u20101\u2009M0 were included. Propensity score matching by age, gender, clinical stage, cT classification, and Charlson Comorbidity Index score was used between those receiving bladder preservation therapy or radical cystectomy. Overall survival (OS), cancer\u2010specific survival (CSS), and disease\u2010free survival (DFS) were compared using the Kaplan\u2013Meier method. Multivariate Cox regression models were used to determine the predictive factors of OS, CSS, and DFS.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Following the propensity score matching, 393 MIBC patients were analyzed, 131 (33.3%) receiving bladder preservation therapy and 262 (66.7%) receiving radical cystectomy. After 5\u2009years of the follow\u2010up period the overall duration was with a median of 15.6\u2009months. The treatment groups did not differ significantly in OS, CSS, and DFS (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.2681, 0.7208, and 0.3616, respectively). In multivariable Cox regression models, bladder preservation therapy remained non\u2010inferior to radical cystectomy in OS (adjusted hazard ratio [aHR] 1.08; 95% confidence interval [CI], 0.77\u20131.50;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.6689), CSS (aHR, 1.06; 95% CI, 0.72\u20131.57;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.7728), and DFS (aHR, 0.76; 95% CI, 0.46\u20131.27;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.2929). Additionally, among patients \u226580\u2009years, the use of bladder preservation therapy compared with radical cystectomy resulted in an equivalent OS, CSS and DSS.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In Asian populations, bladder preservation therapy yielded similar survival outcomes as radical cystectomy in MIBC patients. Based on the results, it is evident that a multidisciplinary approach and shared decision\u2010making are recommended for bladder cancer treatment.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/cam4.6972","type":"journal-article","created":{"date-parts":[[2024,2,7]],"date-time":"2024-02-07T00:54:04Z","timestamp":1707267244000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Comparative survival analysis of bladder preservation therapy versus radical cystectomy in muscle\u2010invasive bladder cancer"],"prefix":"10.1002","volume":"13","author":[{"given":"Nai\u2010Wen","family":"Kang","sequence":"first","affiliation":[{"name":"Division of Hematology and Oncology, Department of Internal Medicine Chi Mei Medical Center  Tainan Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8660-0685","authenticated-orcid":false,"given":"Yin\u2010Hsun","family":"Feng","sequence":"additional","affiliation":[{"name":"Division of Hematology and Oncology, Department of Internal Medicine Chi Mei Medical Center  Tainan Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kuei\u2010Li","family":"Lin","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Chi Mei Medical Center  Tainan Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yi\u2010Chen","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Medical Research Chi Mei Medical Center  Tainan Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chung\u2010Han","family":"Ho","sequence":"additional","affiliation":[{"name":"Department of Medical Research Chi Mei Medical Center  Tainan Taiwan"},{"name":"Department of Information Management Southern Taiwan University of Science and Technology  Tainan Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3823-4673","authenticated-orcid":false,"given":"Ching\u2010Chieh","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Chi Mei Medical Center  Tainan Taiwan"},{"name":"Department of Pharmacy Chia\u2010Nan University of Pharmacy and Science  Tainan Taiwan"},{"name":"School of Medicine, College of Medicine National Sun Yat\u2010sen University  Kaohsiung 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efficacy of trimodal chemoradiotherapy with gemcitabine and cisplatin as a bladder\u2010preserving strategy for the treatment of muscle\u2010invasive bladder cancer: a single\u2010arm phase II study","volume":"52","author":"Kobayashi K","year":"2022","journal-title":"Jpn J Clin Oncol"},{"key":"e_1_2_13_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.radonc.2020.07.057"},{"key":"e_1_2_13_28_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1613683"},{"key":"e_1_2_13_29_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2002788"},{"key":"e_1_2_13_30_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2034442"},{"key":"e_1_2_13_31_1","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21631"},{"key":"e_1_2_13_32_1","doi-asserted-by":"publisher","DOI":"10.1097\/JU.0000000000000813"}],"container-title":["Cancer 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