Timing of radical cystectomy in Central Europe – multicenter study on factors influencing the time from diagnosis to radical treatment of bladder cancer patients

Abstract

Citation: Poletajew S, Braticevici B, Brisuda A, Cauni V, Grygorenko V, Lesnyak M-Z, et al. Timing of radical cystectomy in Central Europe -multicenter study on factors influencing the time from diagnosis to radical treatment of bladder cancer patients. Cent European J Urol. 2015; 68: 9-14. Introduction Time that passes between an unfavourable diagnosis to a radical cystectomy (RC) affects oncological outcomes in patients with bladder cancer. Unsatisfactory survival of patients after RC in Central Europe can potentially result from this factor. Material and methods The aim of this study was to assess the time interval between transurethral resection of the bladder tumor (TURBT) and RC in Central Europe and to identify clinical factors of possible delays. 941 consecutive patients who underwent RC in nine Central European urological centers were enrolled into the study. After the TURBT-RC time was calculated, selected clinical and pathological parameters were tested as potential factors influencing the timing of RC. Results On average, RCs were performed 73.8 days after TURBTs (median -53, range 0-1587). In 238 patients (25.3%) the time exceeded 12 weeks. Patients with muscle-invasive cancer were operated earlier on than patients with nonmuscle-invasive cancer (67.6 vs.105.2 days, RR = 1.41, p = 0.00). In high volume centers (>30 RC per year) longer TURBT-RC intervals were observed (97.6 vs. 66.3 days, RR = 2.49, p = 0.00). Simultaneously, factors such as female sex (RR = 1.21), more advanced age of patient (>65 years, RR = 1.23), presence of concomitant CIS (RR = 2.43), grade of cancer cells (RR = 1.67) and final post-RC stage (RR = 1.51) had no statistically significant effect on the results (p >0.05). Conclusions The mean time interval between the diagnosis and radical treatment of patients with bladder cancer in Central Europe is adequate. However, there are still a relatively high number of patients waiting for radical cystectomy longer than 8 weeks. A lower stage of disease as well as a higher case load within of a hospital may delay the surgery. Article history

ears of life lost due to bladder cancer among the inhabitants of Poland in the years 2000 to 2014

“…The authors note that the mortality rate in Polish centers is much higher than in most published series [ 28 ]. Another analysis of 902 patients who underwent RC found the mean time interval between diagnosis and radical treatment of patients with BC in Central Europe to be adequate, but emphasized that a relatively high number of patients who still had to wait longer than eight weeks for radical cystectomy [ 29 ].…”

Stage of bladder cancer in Central Europe – Polish perspective

“…The data on European patients with bladder cancer come mainly from Western European countries. With latest papers presenting delay in radical cystectomy in over 20% of Central European patients and a 5-year survival following the surgery of 31.7% [3][4][5], one can think about differences in culture, lifestyle and health policy between the region of Central and Western Europe. As a consequence, we decided to perform The main finding of our study is that the stage of primary bladder cancer in Poland differs from literature data.…”

Histopathological evaluation is still useful after bladder neck resection

“…In the end, giving the patient a clear diagnosis will definitely be worth the wait. One solution to reduce this burden for the patient would be to improve the time from surgery to the biopsy results, which can take up to two months as data in the literature suggests [5]. …”