设计用于治疗膀胱转移性尿路上皮癌 (mUCUB) 的几种新型全身疗法出现后，总生存期 (OS) 的改善尚未在当代 UCUB 患者和/或非 UCUB 患者中进行最终研究。在监测、流行病学和最终结果数据库中，确定了当代（2017-2020）和历史（2000-2016）接受全身治疗的转移性 UCUB 患者以及随后的非 UCUB 患者。单独的 Kaplan-Meier 和多变量 Cox 回归 (CRM) 分析首先解决了 mUCUB 中的 OS，随后解决了转移性非 UCUB (mn-UCUB) 中的 OS。在 3443 名接受全身治疗的患者中，2725 名（79%）患有 mUCUB，709 名（21%）患有 mn-UCUB。在 2725 名 mUCUB 患者中，582 名 (21%) 为当代患者 (2017-2020 年)，而 2143 名 (79%) 为历史患者 (2000-2016 年)。在 mUCUB 中，当代患者的中位 OS 为 11 个月，而历史患者的中位 OS 为 8 个月（Δ = 3 个月；p< .0001）。多变量 CRM 后，当代会员状态（2017-2020）独立预测较低的总体死亡率（OM；风险比 [HR] = 0.68，95% 置信区间 [CI] = 0.60-0.76；p < .001）。在 7.09 亿 UCUB 患者中，167 名 (24%) 为当代患者 (2017-2020 年)，542 名 (76%) 为历史患者 (2000-2016 年)。在 mn-UCUB 中，当代患者的中位 OS 为 8 个月，而历史患者的中位 OS 为 7 个月（Δ = 1 个月；p = .034）。多变量 CRM 后，当代会员身份（2017-2020 年）与 HR 相关，HR 为 0.81（95% CI= 0.66-1.01；p= .06）。总之，当代接受全身治疗的转移性患者在 UCUB 中表现出更好的 OS。然而，mUCUB 的生存获益程度高出三倍，接近新型全身疗法前瞻性随机试验中记录的生存获益。© 2024 UICC。

The overall survival (OS) improvement after the advent of several novel systemic therapies, designed for treatment of metastatic urothelial carcinoma of the urinary bladder (mUCUB), is not conclusively studied in either contemporary UCUB patients and/or non-UCUB patients. Within the Surveillance, Epidemiology, and End Results database, contemporary (2017-2020) and historical (2000-2016) systemic therapy-exposed metastatic UCUB and, subsequently, non-UCUB patients were identified. Separate Kaplan-Meier and multivariable Cox regression (CRM) analyses first addressed OS in mUCUB and, subsequently, in metastatic non-UCUB (mn-UCUB). Of 3443 systemic therapy-exposed patients, 2725 (79%) harbored mUCUB versus 709 (21%) harbored mn-UCUB. Of 2725 mUCUB patients, 582 (21%) were contemporary (2017-2020) versus 2143 (79%) were historical (2000-2016). In mUCUB, median OS was 11 months in contemporary versus 8 months in historical patients (Δ = 3 months; p < .0001). After multivariable CRM, contemporary membership status (2017-2020) independently predicted lower overall mortality (OM; hazard ratio [HR] = 0.68, 95% confidence interval [CI] = 0.60-0.76; p < .001). Of 709 mn-UCUB patients, 167 (24%) were contemporary (2017-2020) and 542 (76%) were historical (2000-2016). In mn-UCUB, median OS was 8 months in contemporary versus 7 months in historical patients (Δ = 1 month; p = .034). After multivariable CRM, contemporary membership status (2017-2020) was associated with HR of 0.81 (95% CI = 0.66-1.01; p = .06). In conclusion, contemporary systemic therapy-exposed metastatic patients exhibited better OS in UCUB. However, the magnitude of survival benefit was threefold higher in mUCUB and approximated the survival benefits recorded in prospective randomized trials of novel systemic therapies.© 2024 UICC.