Association Between Surgery and 5-year Survival for Patients Diagnosed with Stage I Bladder Adenocarcinoma

Abstract

Background: Bladder cancer (BC) comprises of various subtypes, each with unique demographic and clinical characteristics. This study leverages the Surveillance, Epidemiology, and End Results (SEER) data to investigate whether surgical intervention is associated with 5-year mortality for patients with stage I bladder adenocarcinoma (BA). Methods: 209 patients met BA eligibility criteria, which included complete demographic data and clinical information. A multivariable logistic regression adjusting for age, ethnicity, gender, and neoadjuvant chemotherapy was used to interrogate the association between surgery versus no surgery on 5-year mortality. Results: Between 1975 and 2021, 115 patients (55%) received a surgical intervention as the primary treatment for stage I BA. Multivariable adjustment for neoadjuvant chemotherapy, ethnicity, age and sex demonstrated that surgery was associated with 64 percent lower likelihood of death (odds ratio [OR] 0.36, 95% confidence interval [CI]: 0.11 – 0.62, p = 0.02). Further analysis revealed a nonsignificant interaction between surgery and neoadjuvant chemotherapy (p-interaction = 0.07), indicating that the association of surgery with death did not significantly differ based on whether patients received neoadjuvant chemotherapy or not. Conclusion: This study suggests that tumor resection may be effective in treating stage I BA, highlighting an observed survival pattern for patients that received a surgery.