Advertisement
Journal of Clinical Oncology  
Search for:
Limit by:
  Browse by Subject or Issue
Home Search or Browse JCO My JCO Subscriptions Customer Service Site Map

This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Purchase Article
Right arrow View Shopping Cart
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a colleague
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Save to my personal folders
Right arrow Download to citation manager
Right arrowRights & Permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Bajorin, D. F.
Right arrow Articles by Boyle, M. G.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Bajorin, D. F.
Right arrow Articles by Boyle, M. G.
Social Bookmarking
Add to CiteULike   Add to Complore   Add to Connotea   Add to Del.icio.us   Add to Digg   Add to Facebook   Add to Reddit   Add to Technorati   Add to Twitter  
What's this?
Journal of Clinical Oncology, Vol 17, Issue 10 (October), 1999: 3173-3181
© 1999 American Society for Clinical Oncology

Long-Term Survival in Metastatic Transitional-Cell Carcinoma and Prognostic Factors Predicting Outcome of Therapy

Dean F. Bajorin, Paul M. Dodd, Madhu Mazumdar, Melissa Fazzari, John A. McCaffrey, Howard I. Scher, Harry Herr, Geralyn Higgins, Mary G. Boyle

From the Genitourinary Oncology Service, Division of Solid Tumor Oncology, Department of Medicine, Division of Urology, Department of Surgery, and Department of Epidemiology and Biostatistics, Memorial Sloan-Kettering Cancer Center, and Department of Medicine, Cornell University Medical College, New York, NY.

Address reprint requests to Dean F. Bajorin, MD, Memorial Sloan-Kettering Cancer Center, 1275 York Ave, New York, NY 10021.

PURPOSE: The variation in reported survival of patients with metastatic transitional-cell carcinoma (TCC) treated with systemic chemotherapy may be a consequence of pretreatment patient characteristics. We hypothesized that a prognostic factor–based model of survival among patients treated with methotrexate, vinblastine, doxorubicin, and cisplatin chemotherapy could account for such differences and help guide clinical trial design and interpretation.

PATIENTS AND METHODS: A database of 203 patients with unresectable or metastatic TCC was retrospectively subjected to a multivariate regression analysis to determine which patient characteristics had independent prognostic significance for survival. Patients were assigned to three risk categories depending on the number of unfavorable characteristics. Patient selection in phase II studies was addressed by developing a table of expected median survival for patient cohorts that had varying proportions of patients from the three risk categories.

RESULTS: Two factors had independent prognosis: Karnofsky performance status (KPS) less than 80% and visceral (lung, liver, or bone) metastasis. Median survival times for patients who had zero, one, or two risk factors were 33, 13.4, and 9.3 months, respectively (P = .0001). The median survival time of patient cohorts could vary from 9 to 26 months simply by altering the proportion of patients from different risk categories.

CONCLUSION: The presence of baseline KPS less than 80% or visceral metastasis has an impact on survival. Reporting the proportion of patients with zero, one, and two risk factors will facilitate understanding of the relevance of the median survival in phase II trials. Phase III trials should stratify patients according to the number of risk factors to avoid imbalance in treatment arms.


Add to CiteULike CiteULike   Add to Complore Complore   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us   Add to Digg Digg   Add to Facebook Facebook   Add to Reddit Reddit   Add to Technorati Technorati   Add to Twitter Twitter    What's this?


This article has been cited by other articles:


Home page
 JCOHome page
J. Bellmunt, C. Theodore, T. Demkov, B. Komyakov, L. Sengelov, G. Daugaard, A. Caty, J. Carles, A. Jagiello-Gruszfeld, O. Karyakin, et al.
Phase III Trial of Vinflunine Plus Best Supportive Care Compared With Best Supportive Care Alone After a Platinum-Containing Regimen in Patients With Advanced Transitional Cell Carcinoma of the Urothelial Tract
J. Clin. Oncol., September 20, 2009; 27(27): 4454 - 4461.
[Abstract] [Full Text] [PDF]

Home page
 JCOHome page
R. Dreicer
Second-Line Chemotherapy for Advanced Urothelial Cancer: Because We Should or Because We Can?
J. Clin. Oncol., September 20, 2009; 27(27): 4444 - 4445.
[Full Text] [PDF]

Home page
 JCOHome page
M. I. Milowsky, D. M. Nanus, F. C. Maluf, S. Mironov, W. Shi, A. Iasonos, J. Riches, A. Regazzi, and D. F. Bajorin
Final Results of Sequential Doxorubicin Plus Gemcitabine and Ifosfamide, Paclitaxel, and Cisplatin Chemotherapy in Patients With Metastatic or Locally Advanced Transitional Cell Carcinoma of the Urothelium
J. Clin. Oncol., September 1, 2009; 27(25): 4062 - 4067.
[Abstract] [Full Text] [PDF]

Home page
 Therapeutic Advances in Medical OncologyHome page
G. Sonpavde, A. A. Elfiky, and J. E. Rosenberg
Review: Novel agents for advanced bladder cancer
Therapeutic Advances in Medical Oncology, July 1, 2009; 1(1): 37 - 50.
[Abstract] [PDF]

Home page
 Ann OncolHome page
G. K. Philips, S. Halabi, B. L. Sanford, D. Bajorin, E. J. Small, and for the Cancer and Leukemia Group B
A phase II trial of cisplatin (C), gemcitabine (G) and gefitinib for advanced urothelial tract carcinoma: results of Cancer and Leukemia Group B (CALGB) 90102
Ann. Onc., June 1, 2009; 20(6): 1074 - 1079.
[Abstract] [Full Text] [PDF]

Home page
 Jpn J Clin OncolHome page
T. Suyama, T. Ueda, S. Fukasawa, Y. Imamura, K. Nakamura, K. Miyasaka, T. Sazuka, K.-i. Egoshi, N. Nihei, M. Hamano, et al.
Combination of Gemcitabine and Paclitaxel as Second-line Chemotherapy for Advanced Urothelial Carcinoma
Jpn. J. Clin. Oncol., April 1, 2009; 39(4): 244 - 250.
[Abstract] [Full Text] [PDF]

Home page
 Molecular Cancer TherapeuticsHome page
T. Inamoto, S. Papineni, S. Chintharlapalli, S.-D. Cho, S. Safe, and A. M. Kamat
1,1-Bis(3'-indolyl)-1-(p-chlorophenyl)methane activates the orphan nuclear receptor Nurr1 and inhibits bladder cancer growth
Mol. Cancer Ther., December 1, 2008; 7(12): 3825 - 3833.
[Abstract] [Full Text] [PDF]

Home page
 Ann OncolHome page
J. E. Rosenberg, S. Halabi, B. L. Sanford, A. L. Himelstein, J. N. Atkins, R. J. Hohl, F. Millard, D. F. Bajorin, E. J. Small, and For the Cancer and Leukemia Group B
Phase II study of bortezomib in patients with previously treated advanced urothelial tract transitional cell carcinoma: CALGB 90207
Ann. Onc., May 1, 2008; 19(5): 946 - 950.
[Abstract] [Full Text] [PDF]

Home page
 Am Soc Clin Oncol Ed BookHome page
W. M. Stadler
Tumor Burden Endpoints and Phase II Clinical Trial Design
ASCO Educational Book, January 1, 2008; 2008(1): 89 - 93.
[Abstract] [Full Text] [PDF]

Home page
 Am Soc Clin Oncol Ed BookHome page
C. Sweeney, D. F. Bajorin, and C. N. Sternberg
Muscle-invasive Bladder Cancer: What Have We Learned and What's New on the Horizon?
ASCO Educational Book, January 1, 2008; 2008(1): 200 - 208.
[Abstract] [Full Text] [PDF]

Home page
 Ann OncolHome page
J Carles, E Esteban, M Climent, A Font, J. Gonzalez-Larriba, A Berrocal, I Garcia-Ribas, X Marfa, X Fabregat, J Albanell, et al.
Gemcitabine and oxaliplatin combination: a multicenter phase II trial in unfit patients with locally advanced or metastatic urothelial cancer
Ann. Onc., August 1, 2007; 18(8): 1359 - 1362.
[Abstract] [Full Text] [PDF]

Home page
 Clin. Cancer Res.Home page
A. B. Als, L. Dyrskjot, H. von der Maase, K. Koed, F. Mansilla, H. E. Toldbod, J. L. Jensen, B. P. Ulhoi, L. Sengelov, K. M.E. Jensen, et al.
Emmprin and Survivin Predict Response and Survival following Cisplatin-Containing Chemotherapy in Patients with Advanced Bladder Cancer
Clin. Cancer Res., August 1, 2007; 13(15): 4407 - 4414.
[Abstract] [Full Text] [PDF]

Home page
 JCOHome page
D. J. Vaughn
Moving Forward in Advanced Bladder Cancer
J. Clin. Oncol., June 1, 2007; 25(16): 2162 - 2163.
[Full Text] [PDF]

Home page
 Ann OncolHome page
J Bellmunt, L Paz-Ares, M Cuello, F. Cecere, S Albiol, V Guillem, E Gallardo, J Carles, P Mendez, J. de la Cruz, et al.
Gene expression of ERCC1 as a novel prognostic marker in advanced bladder cancer patients receiving cisplatin-based chemotherapy
Ann. Onc., March 1, 2007; 18(3): 522 - 528.
[Abstract] [Full Text] [PDF]

Home page
 JCOHome page
J. A. Garcia and R. Dreicer
Systemic Chemotherapy for Advanced Bladder Cancer: Update and Controversies
J. Clin. Oncol., December 10, 2006; 24(35): 5545 - 5551.
[Abstract] [Full Text] [PDF]

Home page
 Ann OncolHome page
I Boukovinas, N Androulakis, L Vamvakas, P Papakotoulas, N Ziras, A Polyzos, A Kalykaki, A Kotsakis, N Xenidis, I Gioulmbasanis, et al.
Sequential gemcitabine and cisplatin followed by docetaxel as first-line treatment of advanced urothelial carcinoma: a multicenter phase II study of the Hellenic Oncology Research Group
Ann. Onc., November 1, 2006; 17(11): 1687 - 1692.
[Abstract] [Full Text] [PDF]

Home page
 Ann OncolHome page
R Sawhney, D Bourgeois, and U. Chaudhary
Neo-adjuvant chemotherapy for muscle-invasive bladder cancer: a look ahead
Ann. Onc., September 1, 2006; 17(9): 1360 - 1369.
[Abstract] [Full Text] [PDF]

Home page
 JCOHome page
C. J. Sweeney, B. J. Roth, F. F. Kabbinavar, D. J. Vaughn, M. Arning, R. E. Curiel, C. K. Obasaju, Y. Wang, S. J. Nicol, and D. S. Kaufman
Phase II Study of Pemetrexed for Second-Line Treatment of Transitional Cell Cancer of the Urothelium
J. Clin. Oncol., July 20, 2006; 24(21): 3451 - 3457.
[Abstract] [Full Text] [PDF]

Home page
 JCOHome page
G. V. Raj, A. Iasonos, H. Herr, and S. M. Donat
Formulas Calculating Creatinine Clearance Are Inadequate for Determining Eligibility for Cisplatin-Based Chemotherapy in Bladder Cancer
J. Clin. Oncol., July 1, 2006; 24(19): 3095 - 3100.
[Abstract] [Full Text] [PDF]

Home page
 Ann OncolHome page
A. Bamias, I. Tiliakos, M.-D. Karali, and M. A. Dimopoulos
Systemic chemotherapy in inoperable or metastatic bladder cancer
Ann. Onc., April 1, 2006; 17(4): 553 - 561.
[Abstract] [Full Text] [PDF]

Home page
 The OncologistHome page
M. D. Galsky
The Role of Taxanes in the Management of Bladder Cancer
Oncologist, November 1, 2005; 10(10): 792 - 798.
[Abstract] [Full Text] [PDF]

Home page
 JCOHome page
H. von der Maase, L. Sengelov, J. T. Roberts, S. Ricci, L. Dogliotti, T. Oliver, M. J. Moore, A. Zimmermann, and M. Arning
Long-Term Survival Results of a Randomized Trial Comparing Gemcitabine Plus Cisplatin, With Methotrexate, Vinblastine, Doxorubicin, Plus Cisplatin in Patients With Bladder Cancer
J. Clin. Oncol., July 20, 2005; 23(21): 4602 - 4608.
[Abstract] [Full Text] [PDF]

Home page
 JCOHome page
J. Li, B. Juliar, C. Yiannoutsos, R. Ansari, E. Fox, M. J. Fisch, L. H. Einhorn, and C. J. Sweeney
Weekly Paclitaxel and Gemcitabine in Advanced Transitional-Cell Carcinoma of the Urothelium: A Phase II Hoosier Oncology Group Study
J. Clin. Oncol., February 20, 2005; 23(6): 1185 - 1191.
[Abstract] [Full Text] [PDF]

Home page
 Ann OncolHome page
A. Bamias, E. Efstathiou, L. A. Moulopoulos, D. Gika, G. Hamilos, M. P. Zorzou, C. Kakoyiannis, E. Kastritis, G. Bozas, C. Papadimitriou, et al.
The outcome of elderly patients with advanced urothelial carcinoma after platinum-based combination chemotherapy
Ann. Onc., February 1, 2005; 16(2): 307 - 313.
[Abstract] [Full Text] [PDF]

Home page
 JCOHome page
A. Bamias, Ch. Deliveliotis, G. Fountzilas, D. Gika, A. Anagnostopoulos, M.P. Zorzou, E. Kastritis, C. Constantinides, P. Kosmidis, and M.A. Dimopoulos
Adjuvant Chemotherapy With Paclitaxel and Carboplatin in Patients With Advanced Carcinoma of the Upper Urinary Tract: A Study by the Hellenic Cooperative Oncology Group
J. Clin. Oncol., June 1, 2004; 22(11): 2150 - 2154.
[Abstract] [Full Text] [PDF]

Home page
 JCOHome page
A. Bamias, G. Aravantinos, C. Deliveliotis, D. Bafaloukos, C. Kalofonos, N. Xiros, A. Zervas, D. Mitropoulos, E. Samantas, D. Pectasides, et al.
Docetaxel and Cisplatin With Granulocyte Colony-Stimulating Factor (G-CSF) Versus MVAC With G-CSF in Advanced Urothelial Carcinoma: A Multicenter, Randomized, Phase III Study From the Hellenic Cooperative Oncology Group
J. Clin. Oncol., January 15, 2004; 22(2): 220 - 228.
[Abstract] [Full Text] [PDF]

Home page
 JCOHome page
D. Bajorin
The Phase III Candidate: Can We Improve the Science of Selection?
J. Clin. Oncol., January 15, 2004; 22(2): 211 - 213.
[Full Text] [PDF]

Home page
 JCOHome page
D.F. Roychowdhury, A. Hayden, and A.M. Liepa
Health-Related Quality-of-Life Parameters as Independent Prognostic Factors in Advanced or Metastatic Bladder Cancer
J. Clin. Oncol., February 15, 2003; 21(4): 673 - 678.
[Abstract] [Full Text] [PDF]

Home page
 JCOHome page
L. C. Pagliaro, R. E. Millikan, S.-M. Tu, D. Williams, D. Daliani, C. N. Papandreou, and C. J. Logothetis
Cisplatin, Gemcitabine, and Ifosfamide As Weekly Therapy: A Feasibility and Phase II Study of Salvage Treatment for Advanced Transitional-Cell Carcinoma
J. Clin. Oncol., July 1, 2002; 20(13): 2965 - 2970.
[Abstract] [Full Text] [PDF]

Home page
 JCOHome page
A. O. Siefker-Radtke, R. E. Millikan, S.-M. Tu, D. F. Moore Jr, T. L. Smith, D. Williams, and C. J. Logothetis
Phase III Trial of Fluorouracil, Interferon Alfa-2b, and Cisplatin Versus Methotrexate, Vinblastine, Doxorubicin, and Cisplatin in Metastatic or Unresectable Urothelial Cancer
J. Clin. Oncol., March 1, 2002; 20(5): 1361 - 1367.
[Abstract] [Full Text] [PDF]

Home page
 JCOHome page
D. J. Vaughn, C. M. Broome, M. Hussain, J. C. Gutheil, and A. B. Markowitz
Phase II Trial of Weekly Paclitaxel in Patients With Previously Treated Advanced Urothelial Cancer
J. Clin. Oncol., February 15, 2002; 20(4): 937 - 940.
[Abstract] [Full Text] [PDF]

Home page
 JCOHome page
C. N. Sternberg, P. H.M. de Mulder, J. H. Schornagel, C. Theodore, S. D. Fossa, A. T. van Oosterom, F. Witjes, M. Spina, C. J. van Groeningen, C. de Balincourt, et al.
Randomized Phase III Trial of High-Dose-Intensity Methotrexate, Vinblastine, Doxorubicin, and Cisplatin (MVAC) Chemotherapy and Recombinant Human Granulocyte Colony-Stimulating Factor Versus Classic MVAC in Advanced Urothelial Tract Tumors: European Organization for Research and Treatment of Cancer Protocol No. 30924
J. Clin. Oncol., May 15, 2001; 19(10): 2638 - 2646.
[Abstract] [Full Text] [PDF]

Home page
 JCOHome page
M. Hussain, U. Vaishampayan, W. Du, B. Redman, and D. C. Smith
Combination Paclitaxel, Carboplatin, and Gemcitabine Is an Active Treatment for Advanced Urothelial Cancer
J. Clin. Oncol., May 1, 2001; 19(9): 2527 - 2533.
[Abstract] [Full Text] [PDF]

Home page
 JCOHome page
J. Bellmunt, V. Guillem, L. Paz-Ares, J. L. Gonzalez-Larriba, J. Carles, E. Batiste-Alentorn, A. Saenz, M. Lopez-Brea, A. Font, M. Nogue, et al.
Phase I-II Study of Paclitaxel, Cisplatin, and Gemcitabine in Advanced Transitional-Cell Carcinoma of the Urothelium
J. Clin. Oncol., September 18, 2000; 18(18): 3247 - 3255.
[Abstract] [Full Text] [PDF]

Home page
 JCOHome page
H. von der Maase, S.W. Hansen, J.T. Roberts, L. Dogliotti, T. Oliver, M.J. Moore, I. Bodrogi, P. Albers, A. Knuth, C.M. Lippert, et al.
Gemcitabine and Cisplatin Versus Methotrexate, Vinblastine, Doxorubicin, and Cisplatin in Advanced or Metastatic Bladder Cancer: Results of a Large, Randomized, Multinational, Multicenter, Phase III Study
J. Clin. Oncol., September 17, 2000; 18(17): 3068 - 3077.
[Abstract] [Full Text] [PDF]

Home page
 JCOHome page
R. Dreicer, J. Manola, B. J. Roth, M. B. Cohen, A. K. Hatfield, and G. Wilding
Phase II Study of Cisplatin and Paclitaxel in Advanced Carcinoma of the Urothelium: An Eastern Cooperative Oncology Group Study
J. Clin. Oncol., March 1, 2000; 18(5): 1058 - 1058.
[Abstract] [Full Text] [PDF]


About
JCO		 Editorial
Roster		 Advertising
Information		 Librarians &
Institutions		 Rights &
Permissions		 PDA Services

Copyright © 1999 by the American Society of Clinical Oncology, Online ISSN: 1527-7755. Print ISSN: 0732-183X
Terms and Conditions of Use
  HighWire Press HighWire Press™ assists in the publication of JCO Online