OBJECTIVES: This study describes the treatment rate and related predictive factors, demographics, and clinical characteristics of patients with mUC who received systemic chemotherapy and/or radiotherapy (or not), in the inpatient setting in Italy.

METHODS: This retrospective observational analysis used hospital discharge data (SDO, Scheda di Dimissione Ospedaliera) to describe incident adult (≥18 years) patients with a first hospitalization for mUC (index) in 2017-2018, identified by a combination of International Classification of Diseases (ICD-9-CM), medical procedure, and Diagnosis Related Group (DRG) codes. A multivariable logistic regression model was fitted to identify factors associated with receiving inpatient chemotherapy and/or radiotherapy (or not).

RESULTS: A total of 3,674 patients with mUC were identified, of whom 27.6% were treated with inpatient chemotherapy and/or radiotherapy, and 72.4% were with neither. In treated and untreated patients, median age at index was 71 and 78 years, 36.5% and 61.5% were ≥75 years old, and mean (SD) Charlson Comorbidity Index (CCI) score was 0.3 (0.8) and 0.6 (1.1), respectively. Primary tumor location was bladder in 87.2% of patients. Cardiovascular disease and renal function impairment were more prevalent in untreated (22.6% and 13.2%) than treated patients (16.7% and 7.8%), respectively. Older age (odds ratio [OR], 0.94 [95% CI, 0.93-0.95]), female sex (0.82 [0.68-0.99]), and higher CCI score (0.83 [0.73-0.93]) were all associated with a lower likelihood of receiving inpatient chemotherapy and/or radiotherapy.

CONCLUSIONS: These real-world findings from a 2017-2018 retrospective longitudinal cohort study indicate that nearly three fourths of patients with mUC did not receive inpatient systemic chemotherapy and/or radiotherapy in Italy, driven by older age, female sex, and high comorbidity burden. Although this study provides a partial capture of inpatient systemic chemotherapy and/or radiotherapy use in Italy, the results are consistent with other European studies with similar designs.