Treatment Patterns and Long-Term Survival Outcomes in Muscle-Invasive Bladder Cancer: A Decade-Long Single-Institution Retrospective Cohort Study

Characteristic	Category	n	%
Age (years)	Median (IQR)	57	47–65
Age (years)	Range	22–89	—
Gender	Male	287	82.2
Gender	Female	62	17.8
Histology	Urothelial (TCC)	337	96.6
Histology	Variant histology*	12	3.4
Tumor Grade	High grade (G3)	309	88.5
Tumor Grade	Intermediate/Low (G2)	40	11.5
Clinical T stage	cT2	80	22.9
	cT3	232	66.4
	cT4	37	10.6
Clinical N stage	cN0	240	68.8
Clinical N stage	cN+ (N1-N3)	109	31.2
Metastatic status	cM0	307	88.0
Metastatic status	cM1	42	12.0
AJCC Stage	Stage II	79	22.6
	Stage III	212	60.7
	Stage IV	58	16.6

* Variant histology includes squamous, adenocarcinoma, and micropapillary variants.

Table 2.

Treatment Distribution.

Treatment Strategy	n (%)
NAC → cystectomy	47 (13.5%)
NAC → CRT/RT	64 (18.3%)
Upfront cystectomy	50 (14.3%)
Definitive CRT	87 (24.9%)
Definitive RT	34 (9.7%)
Palliative treatment	67 (19.2%)

Overall survival by treatment modality Kaplan-Meier overall survival curves stratified by treatment modality, showing significant differences across groups (log-rank p < 0.0001).

Table 3.

Overall Survival by Treatment Group (median OS not reached in curative-intent groups).

Treatment Group	Deaths / N	Mean OS (months)	95% CI
NAC → cystectomy	7 / 47	109.9	97.7–122.1
NAC → CRT/RT	20 / 64	99.5	84.0–114.9
Upfront cystectomy	11 / 50	122.9	104.8–141.0
Definitive CRT	26 / 87	114.6	97.9–131.2
Definitive RT	10 / 34	101.9	78.5–125.3
Palliative	38 / 67	45.1	30.7–59.5

Overall survival by stage at diagnosis Kaplan-Meier overall survival curves stratified by clinical stage, demonstrating progressively worse survival with advancing stage (log-rank p < 0.0001).

Table 4.

Stage-wise Overall Survival in Muscle-Invasive Bladder Cancer.

Stage	Patients (N)	Deaths (Events)	Mean OS (months)	95% Confidence Interval
Stage II	79	18	124.96	107.99 – 141.94
Stage III	212	59	110.40	101.05 – 119.74
Stage IV	58	35	48.39	33.30 – 63.47
Overall	349	112	110.52	101.98 – 119.07

Table 5.

Univariate Cox Regression Analysis for Overall Survival.

Variable	HR	95% CI	p-value
Age (per year)	1.00	0.99–1.02	0.656
Female sex	1.11	0.70–1.76	0.655
Stage III vs II	1.23	0.73–2.08	0.443
Stage IV vs II	4.64	2.62–8.22	<0.001
Palliative vs upfront cystectomy	5.33	2.70–10.50	<0.001

Table 6.

Multivariate Cox Regression Analysis for Overall Survival.

Variable	HR	95% CI	p-value
Age (per year)	1.00	0.98–1.01	0.830
Female sex	1.08	0.69–1.68	0.740
Stage III vs II	1.23	0.68–2.11	0.459
Stage IV vs II	2.41	1.33–4.37	0.0039
Palliative vs upfront cystectomy	3.30	1.49–7.31	0.0034

References

Authors

Metrics

Articles in this issue

DOI: https://doi.org/10.2478/jcas-2026-0016 | Journal eISSN: 2411-989X

Journal RSS Feed

Language: English

Page range: 122 - 128

Published on: Sep 10, 2026

Published by: Shakuat Khanum Memorial Cancer Hospital and Research Centre

In partnership with: Paradigm Publishing Services

Publication frequency: 1 issue per year

Keywords:

Muscle-invasive bladder cancer,

radical cystectomy,

chemoradiotherapy,

neoadjuvant chemotherapy,

overall survival,

low- and middle-income countries

Related subjects:

Medicine,

Clinical medicine,

Internal medicine,

Internal medicine, other,

Haematology, oncology,

Pediatrics and juvenile medicine,

Paediatric haematology and oncology,

Surgery,

Surgery, other

© 2026 Fajar Rafi Ranjha, Asma Rashid, Abdullah Adnan, Muhammad Kashif, Ikrama Tanveer, Tabinda Sadaf, Zile-Huma Hashmi, Amna Munawar, published by Shakuat Khanum Memorial Cancer Hospital and Research Centre
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

Volume 12 (2026): Issue 1 (March 2026)

Treatment Patterns and Long-Term Survival Outcomes in Muscle-Invasive Bladder Cancer: A Decade-Long Single-Institution Retrospective Cohort Study

Figures & Tables

Table 1.

Table 2.

Figure 1.

Table 3.

Figure 2.

Table 4.

Table 5.

Table 6.

Paradigm

My account