{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T09:12:29Z","timestamp":1789809149696,"version":"4.0.1"},"reference-count":16,"publisher":"Walter de Gruyter GmbH","issue":"1","license":[{"start":{"date-parts":[[2026,3,1]],"date-time":"2026-03-01T00:00:00Z","timestamp":1772323200000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/3.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,3,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Muscle-invasive bladder cancer (MIBC) is an aggressive malignancy with heterogeneous treatment approaches and outcomes. Long-term survival data from real-world settings remain limited. We evaluated treatment patterns and 10-year survival outcomes in a large single-institution cohort of patients with MIBC.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods<\/jats:title>\n                    <jats:p>This retrospective cohort study included 349 patients with MIBC who were treated at Shaukat Khanum Cancer Hospital and Research Centre, Pakistan between 2010 and 2020. Treatment strategies comprised neoadjuvant chemotherapy followed by radical cystectomy or definitive chemoradiotherapy or radiotherapy, upfront cystectomy, definitive bladder-preserving chemoradiotherapy, radiotherapy alone, and palliative treatment. Overall survival was estimated using the Kaplan-Meier method and compared using the log-rank test. Univariate and multivariate Cox proportional hazards regression analyses were performed to identify independent prognostic factors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The median age was 57 years, with male predominance of 82.2%. High-grade disease was present in 88.5% of patients. At last follow-up, 67.9% of patients were alive. Overall survival differed significantly across treatment strategies (log-rank p &lt; 0.001). Median overall survival was not reached in curative-intent treatment groups, whereas patients treated with palliative intent had an inferior median overall survival of 30 months. In multivariate analysis, Stage IV disease (adjusted HR 2.41, 95% CI 1.33 to 4.37) and palliative treatment (adjusted HR 3.30, 95% CI 1.49 to 7.31) were independently associated with worse survival. After adjustment, no statistically significant differences in overall survival were observed between definitive surgical and bladder preserving approaches, noting the limitations of non-randomized treatment allocation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Definitive treatment was associated with durable long-term survival in appropriately selected patients. Disease stage and treatment intent remained the dominant determinants of outcome. Bladder-preserving chemoradiotherapy was an effective definitive option in selected patients in this real-world cohort.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.2478\/jcas-2026-0016","type":"journal-article","created":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T08:34:09Z","timestamp":1789806849000},"page":"122-128","source":"Crossref","is-referenced-by-count":0,"title":["Treatment Patterns and Long-Term Survival Outcomes in Muscle-Invasive Bladder Cancer: A Decade-Long Single-Institution Retrospective Cohort Study"],"prefix":"10.2478","volume":"12","author":[{"given":"Fajar Rafi","family":"Ranjha","sequence":"first","affiliation":[{"name":"Department of Clinical and Radiation Oncology , Shaukat Khanum Memorial Cancer Hospital and Research Centre , Lahore , Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Asma","family":"Rashid","sequence":"additional","affiliation":[{"name":"Consultant Clinical Oncologist, Department of Clinical and Radiation Oncology , Shaukat Khanum Memorial Cancer Hospital and Research Centre , Lahore , Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abdullah","family":"Adnan","sequence":"additional","affiliation":[{"name":"Resident, Clinical and Radiation Oncology, Department of Clinical and Radiation Oncology , Shaukat Khanum Memorial Cancer Hospital and Research Centre , Lahore , Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muhammad","family":"Kashif","sequence":"additional","affiliation":[{"name":"Resident, Clinical and Radiation Oncology, Department of Clinical and Radiation Oncology , Shaukat Khanum Memorial Cancer Hospital and Research Centre , Lahore , Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ikrama","family":"Tanveer","sequence":"additional","affiliation":[{"name":"Resident, Clinical and Radiation Oncology, Department of Clinical and Radiation Oncology , Shaukat Khanum Memorial Cancer Hospital and Research Centre , Lahore , Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tabinda","family":"Sadaf","sequence":"additional","affiliation":[{"name":"Consultant Clinical Oncologist, Department of Clinical and Radiation Oncology , Shaukat Khanum Memorial Cancer Hospital and Research Centre , Lahore , Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zile-Huma","family":"Hashmi","sequence":"additional","affiliation":[{"name":"Resident, Clinical and Radiation Oncology, Department of Clinical and Radiation Oncology , Shaukat Khanum Memorial Cancer Hospital and Research Centre , Lahore , Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amna","family":"Munawar","sequence":"additional","affiliation":[{"name":"Jinnah Post Graduate Medical Center , Karachi"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"374","published-online":{"date-parts":[[2026,9,10]]},"reference":[{"key":"2026091908340277326_j_jcas-2026-0016_ref_001","doi-asserted-by":"crossref","unstructured":"Witjes JA, Bruins HM, Cathomas R. European Association of Urology Guidelines on Muscle-Invasive and Metastatic Bladder Cancer: Summary of the 2021 Guidelines. European Urology. 2021;79(1):82\u2013104.","DOI":"10.1016\/j.eururo.2020.03.055"},{"key":"2026091908340277326_j_jcas-2026-0016_ref_002","unstructured":"Galsky MD, Stensland KD, Sfakianos JP. Comparative effectiveness of treatment strategies for muscle invasive bladder cancer. Lancet. 2020;395(10221):554\u201364."},{"key":"2026091908340277326_j_jcas-2026-0016_ref_003","doi-asserted-by":"crossref","unstructured":"Flaig TW, Spiess PE, Agarwal N. NCCN Guidelines Insights: Bladder Cancer, Version 2.2020. Journal of the National Comprehensive Cancer Network. 2020;18(3):329\u201354. doi:10.6004\/jnccn.2020.0017","DOI":"10.6004\/jnccn.2020.0017"},{"key":"2026091908340277326_j_jcas-2026-0016_ref_004","doi-asserted-by":"crossref","unstructured":"Grossman HB, Natale RB, Tangen CM, Speights V, Vogelzang NJ, Trump DL, et al. Neoadjuvant chemotherapy plus cystectomy compared with cystectomy alone for locally advanced bladder cancer. New England Journal of Medicine. 2003;349(9):859\u201366.","DOI":"10.1056\/NEJMoa022148"},{"key":"2026091908340277326_j_jcas-2026-0016_ref_005","doi-asserted-by":"crossref","unstructured":"Seisen T, Sun M, Lipsitz SR, Abdollah F, Leow JJ, Menon M, et al. Comparative effectiveness of trimodal therapy versus radical cystectomy for localized muscle-invasive urothelial carcinoma of the bladder. European urology. 2017;72(4):483\u20137.","DOI":"10.1016\/j.eururo.2017.03.038"},{"key":"2026091908340277326_j_jcas-2026-0016_ref_006","doi-asserted-by":"crossref","unstructured":"Yin M, Joshi M, Meijer RP, Glantz M, Holder S, Harvey HA, et al. Neoadjuvant chemotherapy for muscle-invasive bladder cancer: a systematic review and two-step meta-analysis. The oncologist. 2016;21(6):708\u201315.","DOI":"10.1634\/theoncologist.2015-0440"},{"key":"2026091908340277326_j_jcas-2026-0016_ref_007","unstructured":"Zargar-Shoshtari K, Zargar H, Lotan Y, Shah JB, van Rhijn BW, Daneshmand S, et al. A multi-institutional analysis of outcomes of patients with muscle-invasive bladder cancer treated with neoadjuvant chemotherapy followed by cystectomy. Journal of Clinical Oncology. 2016;34(17):1934\u201340."},{"key":"2026091908340277326_j_jcas-2026-0016_ref_008","doi-asserted-by":"crossref","unstructured":"Dash A, Pettus IV JA, Herr HW, Bochner BH, Dalbagni G, Donat SM, et al. A role for neoadjuvant gemcitabine plus cisplatin in muscle-invasive urothelial carcinoma of the bladder: a retrospective experience. Cancer. 2008;113(9):2471\u20137.","DOI":"10.1002\/cncr.23848"},{"key":"2026091908340277326_j_jcas-2026-0016_ref_009","doi-asserted-by":"crossref","unstructured":"James ND, Hussain SA, Hall E, Jenkins P, Tremlett J, Rawlings C, et al. Radiotherapy with or without chemotherapy in muscle-invasive bladder cancer. New England Journal of Medicine. 2012;366(16):1477\u201388.","DOI":"10.1056\/NEJMoa1106106"},{"key":"2026091908340277326_j_jcas-2026-0016_ref_010","doi-asserted-by":"crossref","unstructured":"James ND, Hussain SA, Hall E, Jenkins P, Tremlett J, Rawlings C, et al. Long-term outcomes of radiotherapy with or without chemotherapy for muscle invasive bladder cancer: ten-year follow-up of the BC2001 trial. Journal of Clinical Oncology. 2022;40(4):384\u201394. doi:10.1200\/JCO.21.01506","DOI":"10.1200\/JCO.21.01506"},{"key":"2026091908340277326_j_jcas-2026-0016_ref_011","doi-asserted-by":"crossref","unstructured":"Mak RH, Hunt D, Shipley WU, Efstathiou JA, Tester WJ, Hagan MP, et al. Long-term outcomes in patients with muscle-invasive bladder cancer after selective bladder-preserving combined-modality therapy: a pooled analysis of Radiation Therapy Oncology Group protocols 8802, 8903, 9506, 9706, 9906, and 0233. Journal of Clinical Oncology. 2014;32(34):3801\u20139.","DOI":"10.1200\/JCO.2014.57.5548"},{"key":"2026091908340277326_j_jcas-2026-0016_ref_012","doi-asserted-by":"crossref","unstructured":"Giacalone NJ, Shipley WU, Clayman RH, Niemierko A, Drumm M, Heney NM, et al. Long-term outcomes after bladder-preserving tri-modality therapy for patients with muscle-invasive bladder cancer: an updated analysis of the Massachusetts General Hospital experience. European urology. 2017;71(6):952\u201360.","DOI":"10.1016\/j.eururo.2016.12.020"},{"key":"2026091908340277326_j_jcas-2026-0016_ref_013","doi-asserted-by":"crossref","unstructured":"Hamad J, McCloskey H, Milowsky MI, Royce T, Smith A. Bladder preservation in muscle-invasive bladder cancer: a comprehensive review. International braz j urol. 2020;46(2):169\u201384.","DOI":"10.1590\/s1677-5538.ibju.2020.99.01"},{"key":"2026091908340277326_j_jcas-2026-0016_ref_014","doi-asserted-by":"crossref","unstructured":"Gupta S, Hensley PJ, Li R, Choudhury A, Daneshmand S, Faltas BM, et al. Bladder preservation strategies in muscle-invasive bladder cancer: recommendations from the International Bladder Cancer Group. European urology. 2025.","DOI":"10.1016\/j.eururo.2025.03.017"},{"key":"2026091908340277326_j_jcas-2026-0016_ref_015","unstructured":"Moschini M, Shariat SF, Roupr\u00eat M, et al. Impact of surgical delay on outcomes in patients with muscle invasive bladder cancer. European Urology Focus. 2021;7(1):89\u201397."},{"key":"2026091908340277326_j_jcas-2026-0016_ref_016","doi-asserted-by":"crossref","unstructured":"Vetterlein MW, Gild P, Kluth LA, Soave A, Dahlem R, Fisch M, et al. Conditional survival of patients with muscle invasive bladder cancer. European Urology. 2020;77(4):553\u201361. doi:10.1016\/j.eururo.2019.11.019","DOI":"10.1016\/j.eururo.2019.11.019"}],"container-title":["Journal of Cancer and Allied Specialties"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/reference-global.com\/pdf\/10.2478\/jcas-2026-0016","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T08:34:14Z","timestamp":1789806854000},"score":1,"resource":{"primary":{"URL":"https:\/\/reference-global.com\/article\/10.2478\/jcas-2026-0016"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,1]]},"references-count":16,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,9,10]]},"published-print":{"date-parts":[[2026,3,1]]}},"alternative-id":["10.2478\/jcas-2026-0016"],"URL":"https:\/\/doi.org\/10.2478\/jcas-2026-0016","relation":{},"ISSN":["2411-989X"],"issn-type":[{"value":"2411-989X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3,1]]}}}