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Second-look resection for primary stage T1 bladder cancer : a population-based study

Patschan, Oliver LU ; Holmäng, Sten; Hosseini, Abolfazl; Jancke, Georg LU ; Liedberg, Fredrik LU ; Ljungberg, Börje; Malmström, Per Uno LU ; Rosell, Johan and Jahnson, Staffan (2017) In Scandinavian Journal of Urology2013-01-01+01:00 51(4). p.301-307
Abstract

Objective: This study aimed to evaluate the use of second-look resection (SLR) in stage T1 bladder cancer (BC) in a population-based Swedish cohort. Materials and methods: All patients diagnosed with stage T1 BC in 2008–2009 were identified in the Swedish National Registry for Urinary Bladder Cancer. Registry data on TNM stage, grade, primary treatment and pathological reports from the SLR performed within 8 weeks of the primary transurethral resection were validated against patient charts. The endpoint was cancer-specific survival (CSS). Results: In total, 903 patients with a mean age of 74 years (range 28–99 years) were included. SLR was performed in 501 patients (55%), who had the following stages at SLR: 172 (35%) T0, 83 (17%)... (More)

Objective: This study aimed to evaluate the use of second-look resection (SLR) in stage T1 bladder cancer (BC) in a population-based Swedish cohort. Materials and methods: All patients diagnosed with stage T1 BC in 2008–2009 were identified in the Swedish National Registry for Urinary Bladder Cancer. Registry data on TNM stage, grade, primary treatment and pathological reports from the SLR performed within 8 weeks of the primary transurethral resection were validated against patient charts. The endpoint was cancer-specific survival (CSS). Results: In total, 903 patients with a mean age of 74 years (range 28–99 years) were included. SLR was performed in 501 patients (55%), who had the following stages at SLR: 172 (35%) T0, 83 (17%) Ta/Tis, 210 (43%) T1 and 26 (5%) T2–4. The use of SLR varied from 18% to 77% in the six healthcare regions. Multiple adjuvant intravesical instillations were given to 420 patients (47%). SLR was associated with intravesical instillations, age younger than 74 years, discussion at multidisciplinary tumour conference, G3 tumour and treatment at high-volume hospitals. Patients undergoing SLR had a lower risk of dying from BC (hazard ratio 0.62, 95% confidence interval 0.45–0.84, p < .0022). Five-year CSS rates were as follows, in patients with the indicated tumours at SLR (p = .001): 82% in those with T1, 90% in T0, 90% in Ta/Tis and 56% in T2–4. Conclusions: There are large geographical differences in the use of SLR in stage T1 BC in Sweden, which are presumably related to local treatment traditions. Patients treated with SLR have a high rate of residual tumour but lower age, which suggests that a selection bias affects CSS.

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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Bladder cancer, cancer-specific survival, population-based, second-look resection, stage T1
in
Scandinavian Journal of Urology2013-01-01+01:00
volume
51
issue
4
pages
7 pages
publisher
Taylor & Francis
external identifiers
  • scopus:85017435624
  • wos:000405483400012
ISSN
2168-1805
DOI
10.1080/21681805.2017.1303846
language
English
LU publication?
yes
id
42e6aa7b-ddbf-4043-9e7e-a018bde5259e
date added to LUP
2017-05-23 11:14:18
date last changed
2017-09-20 09:44:49
@article{42e6aa7b-ddbf-4043-9e7e-a018bde5259e,
  abstract     = {<p>Objective: This study aimed to evaluate the use of second-look resection (SLR) in stage T1 bladder cancer (BC) in a population-based Swedish cohort. Materials and methods: All patients diagnosed with stage T1 BC in 2008–2009 were identified in the Swedish National Registry for Urinary Bladder Cancer. Registry data on TNM stage, grade, primary treatment and pathological reports from the SLR performed within 8 weeks of the primary transurethral resection were validated against patient charts. The endpoint was cancer-specific survival (CSS). Results: In total, 903 patients with a mean age of 74 years (range 28–99 years) were included. SLR was performed in 501 patients (55%), who had the following stages at SLR: 172 (35%) T0, 83 (17%) Ta/Tis, 210 (43%) T1 and 26 (5%) T2–4. The use of SLR varied from 18% to 77% in the six healthcare regions. Multiple adjuvant intravesical instillations were given to 420 patients (47%). SLR was associated with intravesical instillations, age younger than 74 years, discussion at multidisciplinary tumour conference, G3 tumour and treatment at high-volume hospitals. Patients undergoing SLR had a lower risk of dying from BC (hazard ratio 0.62, 95% confidence interval 0.45–0.84, p &lt; .0022). Five-year CSS rates were as follows, in patients with the indicated tumours at SLR (p = .001): 82% in those with T1, 90% in T0, 90% in Ta/Tis and 56% in T2–4. Conclusions: There are large geographical differences in the use of SLR in stage T1 BC in Sweden, which are presumably related to local treatment traditions. Patients treated with SLR have a high rate of residual tumour but lower age, which suggests that a selection bias affects CSS.</p>},
  author       = {Patschan, Oliver and Holmäng, Sten and Hosseini, Abolfazl and Jancke, Georg and Liedberg, Fredrik and Ljungberg, Börje and Malmström, Per Uno and Rosell, Johan and Jahnson, Staffan},
  issn         = {2168-1805},
  keyword      = {Bladder cancer,cancer-specific survival,population-based,second-look resection,stage T1},
  language     = {eng},
  month        = {03},
  number       = {4},
  pages        = {301--307},
  publisher    = {Taylor & Francis},
  series       = {Scandinavian Journal of Urology2013-01-01+01:00},
  title        = {Second-look resection for primary stage T1 bladder cancer : a population-based study},
  url          = {http://dx.doi.org/10.1080/21681805.2017.1303846},
  volume       = {51},
  year         = {2017},
}