Article

Treatment delay and prognosis in invasive bladder cancer.

Department of Urology, Lund University Hospital, Lund, Sweden.
The Journal of Urology (impact factor: 3.75). 12/2005; 174(5):1777-81; discussion 1781. DOI:10.1097/01.ju.0000177521.72678.61 pp.1777-81; discussion 1781
Source: PubMed

ABSTRACT We studied treatment delay, and the impact on disease specific survival and stage progression in a series of patients who had undergone cystectomy.
All 141 patients underwent radical cystectomy between 1990 and 1997 due to locally advanced bladder cancer. Treatment delay was defined as time from pathological confirmation of invasive disease to performance of cystectomy, and was registered retrospectively from the patient charts. Two patients received neoadjuvant chemotherapy and were excluded from further analyses. Followup continued until April 2003 with death due to bladder cancer as the end point. Causes of death were retrieved from the Swedish Cause of Death Registry.
The median treatment delay was 49 days, but was significantly longer for the 71 cases who were referred from other hospitals (63 vs 41 days, p < 0.001). Treatment delay did not influence cumulative incidence of death from bladder cancer. Considering all cases, there was no significant correlation between treatment delay and stage progression. For clinical stage T2 tumors, median treatment delay was 76 days among patients with stage progression compared to 41 and 48 days for those with stage regression and stage equivalence, respectively (p = 0.20).
Treatment delay was not found to influence disease specific survival in the present study. Furthermore, treatment delay was not significantly longer in cases that progressed compared to those with equal or lower pathological stage in the cystectomy specimen.

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    Article: Interval from diagnosis to treatment onset for six major cancers in Catalonia, Spain.
    Glòria Pérez, Miquel Porta, Carme Borrell, Montse Casamitjana, Xavier Bonfill, Ignasi Bolibar, Esteve Fernández
    [show abstract] [hide abstract]
    ABSTRACT: Targets set by health care organizations on time intervals between cancer diagnosis and treatment often go unmet. The objective of the study was to analyse the interval from diagnosis to treatment onset, and related factors, in the six most incident cancers in Catalonia (Spain), a developed European region with universal free access to health care. Twenty-two hospitals contributed 1023 incident cancer patients (198 lung, 253 colorectal, 95 prostate, 109 urinary bladder, 266 breast, 102 endometrial). Information was gathered from hospital medical records. The dependent variable was the length of the diagnosis to treatment interval (DTI). Independent variables were age, sex, disease stage, hospital level, mode of admission to hospital, and type of physician seen before admission. Multivariate-adjusted odds ratios were calculated by unconditional logistic regression for each cancer site. The median DTI (in days) was 39 for lung cancer, 25 for colorectal, 108 for prostate, 69 for bladder, 35 for breast and 40 for endometrial cancer. In prostate and bladder cancers, over 78% of patients showed a DTI >30 days, while in colorectal the figure was 42%. Disseminated stage (distant metastases) was associated with a lower DTI in all sites. Patients admitted to third-level hospitals and with an elective admission were more likely to have a DTI >30 days. In Catalonia, a substantial proportion of cancer patients experience treatment delays that may impact negatively on psychological well-being, quality of life, and probably survival as well.
    Cancer Detection and Prevention 10/2008; 32(3):267-75. · 2.52 Impact Factor
Data provided are for informational purposes only. Although carefully collected, accuracy cannot be guaranteed. The impact factor represents a rough estimation of the journal's impact factor and does not reflect the actual current impact factor. Publisher conditions are provided by RoMEO. Differing provisions from the publisher's actual policy or licence agreement may be applicable.

Keywords

bladder cancer
 
cases
 
Causes
 
clinical stage T2 tumors
 
cystectomy
 
cystectomy specimen
 
Death Registry
 
disease specific survival
 
end point
 
influence disease specific survival
 
invasive disease
 
median treatment delay
 
neoadjuvant chemotherapy
 
pathological confirmation
 
patient charts
 
radical cystectomy
 
stage progression
 
stage regression
 
Swedish Cause
 
Treatment delay
 

Fredrik Liedberg