التفاصيل البيبلوغرافية
| العنوان: |
Muscle-invasive bladder cancer: evaluating treatment and survival in the National Cancer Data Base. |
| المؤلفون: |
Smith, Angela B., Deal, Allison M., Woods, Michael E., Wallen, Eric M., Pruthi, Raj S., Chen, Ronald C., Milowsky, Matthew I., Nielsen, Matthew E. |
| المصدر: |
BJU International; Nov2014, Vol. 114 Issue 5, p719-726, 8p |
| مصطلحات موضوعية: |
BLADDER cancer, URINARY organs, CARCINOGENS, DATA analysis, TUMORS |
| مستخلص: |
Objective To evaluate the association between patterns of care and patient survival for the treatment of muscle-invasive bladder cancer ( MIBC) using a large, national database. Patients and Methods We identified a cohort of 36 469 patients with MIBC (stage II) from 1998 to 2010 from the National Cancer Data Base. Patients were stratified into four treatment groups: radical cystectomy, chemo-radiation, other therapy, or no treatment. Overall survival ( OS) among the groups was evaluated using Kaplan- Meier analysis and the log rank test. A multivariable Cox proportional hazards model was fit to evaluate the association between treatment groups and OS. Results In all, 27% of patients received radical cystectomy, 10% chemo-radiation, 61% other therapy and 2% no treatment. Unadjusted Kaplan- Meier analysis showed significant differences by treatment group, with cystectomy having the greatest median OS (48 months) followed by chemo-radiation (28 months), other therapy (20 months), and no treatment (5 months). When controlling for multiple covariates, the OS for cystectomy was similar to that for chemo-radiation (hazard ratio [ HR] 1.05, 95% confidence interval [ CI] 0.98, 1.12), but superior to other therapy ( HR 1.42; 95% CI 1.35, 1.48), and no treatment ( HR 2.40; 95% CI 2.12, 2.72). The OS time for chemo-radiation was superior to other therapy and no treatment. Conclusions Radical cystectomy and chemo-radiation are significantly underused despite a substantial survival benefit compared with other therapies or no treatment. Future studies are needed to optimise care delivery and improve outcomes for patients with MIBC. [ABSTRACT FROM AUTHOR] |
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| قاعدة البيانات: |
Complementary Index |
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