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The following is a summary of “Characteristics, management and survival outcomes in patients with muscle-invasive bladder cancer at high risk of recurrence in France: a subgroup analysis from the coblance cohort,” published in the May 2025 issue of BMC Urology by Fraslin et al. 

Researchers conducted a retrospective study to define the characteristics, management, disease-free survival, and overall survival (OS) of individuals with high-risk muscle-invasive bladder cancer (MIBC) undergoing radical cystectomy (RC) in France, including a subgroup managed with active surveillance (MIBC-HR-ASO) without adjuvant chemotherapy.  

They identified individuals aged 18 years or older with MIBC who underwent RC between October 2012 and June 2018 from the COBLAnCE bladder cancer cohort. Those with metastatic disease were excluded from the analysis. Individuals were categorized as high-risk MIBC (MIBC-HR) based on Tumour Node Metastasis System (TNM) staging. Disease-free and OS were calculated using the Kaplan-Meier method, and 95% CI were reported for each estimate.  

The results showed that 256 individuals with MIBC at MIBC-HR were included, with a median age of 68.5 years and 204 men (79.7%). A total of 201 (78.5%) were current or former smokers. For staging, 226 (88.3%) had (y)pT3a or higher, and 132 (51.6%) were N-. Neoadjuvant chemotherapy was given to 46 (18.0%) individuals, and 69 (27.0%) received adjuvant chemotherapy, of whom 59 (86.8%) were treated with cisplatin-based regimens. The MIBC-HR-ASO subgroup included 182 individuals (71.1%). A total of 175 (68.3%) experienced an event during follow-up. The median follow-up was 5.0 years. Median disease-free survival was 1.30 years [95% CI: 1.01–1.60] in the MIBC-HR group and 1.21 years [95% CI: 0.70–1.53] in the MIBC-HR-ASO subgroup. Median OS reached 2.31 years 95% CI: 1.85–3.10] in the MIBC-HR group and 2.11 years [95% CI: 1.61–2.65] in the MIBC-HR-ASO group. At 5 years, disease-free survival was 27.4% [21.7;33.9%] in the MIBC-HR group and 23.7% [17.4;31.4%] in the MIBC-HR-ASO group, while OS was 33.2% [27.1;40.0%] and 29.6% [22.7;37.7%], respectively.  

Investigators concluded that real-world data highlighted the poor prognosis of patients with MIBC-HR treated with RC, irrespective of adjuvant chemotherapy, suggesting that novel treatment strategies like immunotherapies might improve overall survival in this cancer type, particularly given the absence of highly effective existing treatments. 

Source: bmcurol.biomedcentral.com/articles/10.1186/s12894-025-01792-w