Bladder Cancer

Clark, Peter E.; Agarwal, Neeraj; Biagioli, Matthew C.; Eisenberger, Mario A.; Greenberg, Richard E.; Herr, Harry W.; Inman, Brant A.; Kuban, Deborah A.; Kuzel, Timothy M.; Lele, Subodh M.; Michalski, Jeff M.; Pagliaro, Lance C.; Pal, Sumanta K.; Patterson, Anthony; Plimack, Elizabeth R.; Pohar, Kamal S.; Porter, Michael P.; Richie, Jerome P.; Sexton, Wade J.; Shipley, William U.; Small, Eric J.; Spiess, Philippe E.; Trump, Donald L.; Wile, Geoffrey; Wilson, Timothy G.; Dwyer, Mary A.; Ho, Maria M.

doi:10.6004/jnccn.2013.0059

Cited by 327 publications

(274 citation statements)

References 85 publications

(117 reference statements)

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“…25 However, our results together with recently published data suggest that efforts should be made to increase guideline compliant care with regard to the use of this therapeutic approach. 26,27 It should also be noted that women were had higher odds of pOT and transfusions. This is in line with previous studies, 20,28 and highlights that RC might be more challenging in women.…”

Section: Discussionmentioning

confidence: 99%

Short-term perioperative outcomes of patients treated with radical cystectomy for bladder cancer included in the National Surgical Quality Improvement Program (NSQIP) database

Gandaglia

Varda

Sood

et al. 2014

CUAJ

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Introduction: We report the contemporary outcomes of radical cystectomy (RC) in patients with bladder cancer using a national, prospective perioperative database specifically developed to assess the quality of surgical care. Methods: The National Surgical Quality Improvement Program (NSQIP) database was queried from 2006 to 2011 for RC. Data on postoperative complications, operative time, length of stay, blood transfusions, readmission, and mortality within 30 days from surgery were abstracted. Results: Overall, 1094 patients undergoing RC were identified. Rates of overall complications, transfusions, prolonged length of hospitalization, readmission, and perioperative mortality were 31.1%, 34.4%, 25.9%, 20.2%, and 2.7%, respectively. Body mass index represented an independent predictor of overall complications on multivariate analysis (p = 0.04). Baseline comorbidity status was associated with increased odds of postoperative complications, prolonged operative time, transfusion, prolonged hospitalization, and perioperative mortality. In particular, patients with cardiovascular comorbidities were 2.4 times more likely to die within 30 days following cystectomy compared to their healthier counterparts (p = 0.04). Men had lower odds of prolonged operative time and blood transfusions (p ≤ 0.03). Finally, the receipt of a continent urinary diversion was the only predictor of readmission (p = 0.02). Our results are limited by their retrospective nature and by the lack of adjustment for hospital and tumour volume. Conclusions: Complications, transfusions, readmission, and perioperative mortality remain relatively common events in patients undergoing RC for bladder cancer. In an era where many advocate the need for prospective multi-institutional data collection as a means of improving quality of care, our study provides data on short-term outcomes after RC from a national quality improvement initiative.

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Section: Discussionmentioning

confidence: 99%

Short-term perioperative outcomes of patients treated with radical cystectomy for bladder cancer included in the National Surgical Quality Improvement Program (NSQIP) database

Gandaglia

Varda

Sood

et al. 2014

CUAJ

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“…The main target of the grading classification for bladder cancer promoted by the ISUP in 1998, and adopted by the WHO in 2004, was the improvement in NMIBC clinical prognostic stratification between patients with low-and high-risk disease, reducing at the same time both intra-and [11][12][13]. According to the EORTC risk tables, all pT1 G3 tumours should be considered at high risk for recurrence and progression and treated accordingly; however, it is not certain that we can translate this statement directly to the overall population with pT1 high grade tumours.…”

Section: Discussionmentioning

confidence: 99%

Oncological predictive value of the 2004 World Health Organisation grading classification in primary T1 non‐muscle‐invasive bladder cancer. A step forward or back?

et al. 2014

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ObjectiveTo compare the clinical reliability of the 1973 and 2004 World Health Organisation (WHO) classification systems in pT1 bladder cancer. Patients and MethodsWe retrospectively evaluated 291 consecutive patients who had pT1 high grade bladder cancer between 2004 and 2011. All tumours were simultaneously evaluated by a single uro-pathologist as high grade and G2 or G3. All patients underwent a second transurethral resection (TUR) and those confirmed with non-muscle-invasive bladder cancer at second TUR received bacille Calmette-Guérin. Follow-up included urine cytology and cystoscopy 3 months after second TUR and then every 6 months for 5 years. Univariate and multivariate analysis to determine recurrence-free survival (RFS) and progression-free survival (PFS) rates were performed using the Kaplan-Meier method with the log-rank test. ResultsG2 tumours were found in 124 (46.6%) and G3 in 142 (53.4%) patients. The mean (median; range) follow-up period was 31.1 (19; 1-93) months. The 5-year RFS rate was 39.1% for the overall high grade population, and 49.1 and 31.8% for G2 and G3 subgroups, respectively. The 5-year PFS was 82% for the overall high grade population and 89 and 73% for G2 and G3 subgroups, respectively. RFS (P < 0.002) and PFS (P < 0.001) rates were significantly different between the G2 and G3 subgroups. In multivariate analysis, only the grade assessed according to the 1973 WHO significantly correlated with both RFS (P = 0.003) and PFS (P < 0.001). ConclusionThe results suggest that the 1973 WHO classification system has higher prognostic reliability for patients with T1 disease. If confirmed, these findings should be carefully taken into account when making treatment decisions for patients with T1 bladder cancer.

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“…Currently, about 10% of patients will present with metastatic UCUB at diagnosis. 21 Based on our data, at least 1 in 4 hospitalized patients with mUCUB will harbor bone metastases. In high-risk patients, such as those with thoracic and brain metastases, virtually every second individual harbors bone metastases.…”

Section: E153mentioning

confidence: 73%

Age-stratified distribution of metastatic sites in bladder cancer: A population-based analysis

Bianchi¹,

Roghmann²,

Becker³

et al. 2014

CUAJ

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Introduction: Urothelial carcinoma of the urinary bladder (UCUB) is the most common malignancy of the urinary tract. We examined the distribution of site-specific metastases in patients with UCUB according to age and we assessed contemporary recommendations proposed by guidelines with regard to distant metastases. Methods: Patients with metastatic UCUB (mUCUB) were abstracted from the Nationwide Inpatient Sample (1998)(1999)(2000)(2001)(2002)(2003)(2004)(2005)(2006)(2007). Age was stratified into quartiles: ≤63, 64-72, 73-79 and ≥80 years. CochranArmitage trend test and multivariable logistic regression analysis tested the relationship between age and the rate of metastases. Finally, we identified patients at high risk of brain or bone metastases. Results: Within 7543 patients with mUCUB, 25%, 24%, 23%, 19%, 18% and 3% had lymph node, bone, urinary, lung and liver metastases, respectively. Overall, the rate of concomitant metastases was 29%. The rate of multiple metastatic sites decreased with increasing age (p < 0.001). This was confirmed in patients with lung, bone, liver, urinary system and brain metastases (all p ≤ 0.04). The rate of bone metastases was 15.0% in patients with exclusive abdominal metastases and 40.0% in patients with abdominal, thoracic and brain metastases. The rate of brain metastases was 1% in patients with exclusive abdominal metastases and 7% in patients with thoracic and bone metastases. Our findings are limited by the retrospective nature of the analyses. Conclusions: We report a higher number of concomitant metastatic sites in young UCUB patients. Bone metastases are frequent in all patient groups, whereas brain metastases are common in UCUB patients with thoracic and/or bone metastases.

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Bladder Cancer

Cited by 327 publications

References 85 publications

Short-term perioperative outcomes of patients treated with radical cystectomy for bladder cancer included in the National Surgical Quality Improvement Program (NSQIP) database

Short-term perioperative outcomes of patients treated with radical cystectomy for bladder cancer included in the National Surgical Quality Improvement Program (NSQIP) database

Oncological predictive value of the 2004 World Health Organisation grading classification in primary T1 non‐muscle‐invasive bladder cancer. A step forward or back?

Age-stratified distribution of metastatic sites in bladder cancer: A population-based analysis

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