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Local recurrence and progression of non-muscle-invasive bladder cancer in Sweden: a population-based follow-up study.

Liedberg, Fredrik LU ; Hagberg, Oskar LU ; Holmäng, Sten; Hosseini Aliabad, Abolfazl; Jancke, Georg; Ljungberg, Börje; Malmström, Per-Uno; Åberg, Hanna and Jahnson, Staffan (2015) In Scandinavian Journal of Urology2013-01-01+01:00 49(4). p.290-295
Abstract
Abstract Objective. The aim of this study was to investigate recurrence and progression of non-muscle-invasive bladder cancer (NMIBC) in a large population-based setting. Materials and methods. Patients with bladder cancer (stage Ta, T1 or carcinoma in situ) diagnosed in 2004-2007 (n = 5839) in Sweden were investigated 5 years after diagnosis using a questionnaire. Differences in time to recurrence and progression were analysed in relation to age, gender, tumour stage and grade, intravesical treatment, healthcare region, and hospital volume of NMIBC patients (stratified in three equally large groups). Results. Local bladder recurrence and progression occurred in 50 and 9% of the patients, respectively. The rate of local recurrence was 56%... (More)
Abstract Objective. The aim of this study was to investigate recurrence and progression of non-muscle-invasive bladder cancer (NMIBC) in a large population-based setting. Materials and methods. Patients with bladder cancer (stage Ta, T1 or carcinoma in situ) diagnosed in 2004-2007 (n = 5839) in Sweden were investigated 5 years after diagnosis using a questionnaire. Differences in time to recurrence and progression were analysed in relation to age, gender, tumour stage and grade, intravesical treatment, healthcare region, and hospital volume of NMIBC patients (stratified in three equally large groups). Results. Local bladder recurrence and progression occurred in 50 and 9% of the patients, respectively. The rate of local recurrence was 56% in the southern healthcare region compared to 37% in the northern region. A multivariate Cox proportional hazards model, adjusting for age, gender, tumour stage and grade, intravesical treatment, healthcare region and hospital volume, showed that recurrence was associated with TaG2 and T1 disease, no intravesical treatment and treatment in the southern healthcare region, but indicated a lower risk of recurrence in the northern healthcare region. Adjusting for the same factors in a multivariate analysis suggested that increased relative risk of progression correlated with older age, higher tumour stage and grade, and diagnosis in the Uppsala/Örebro healthcare region, whereas such risk was decreased by intravesical treatment (relative risk 0.72, 95% confidence interval 0.55-0.93, p = 0.012). Conclusions. The incidence of NMIBC recurrence and progression was found to be high in Sweden, and important disparities in outcome related to care patterns appear to exist between different healthcare regions. (Less)
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organization
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type
Contribution to journal
publication status
published
subject
in
Scandinavian Journal of Urology2013-01-01+01:00
volume
49
issue
4
pages
290 - 295
publisher
Taylor & Francis
external identifiers
  • pmid:25624049
  • wos:000359170200004
  • scopus:84937555640
ISSN
2168-1813
DOI
10.3109/21681805.2014.1000963
language
English
LU publication?
yes
id
ad8eb9b4-48bb-4f41-ad2e-93e20be82011 (old id 5039599)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/25624049?dopt=Abstract
date added to LUP
2015-02-04 17:59:48
date last changed
2017-10-22 03:32:28
@article{ad8eb9b4-48bb-4f41-ad2e-93e20be82011,
  abstract     = {Abstract Objective. The aim of this study was to investigate recurrence and progression of non-muscle-invasive bladder cancer (NMIBC) in a large population-based setting. Materials and methods. Patients with bladder cancer (stage Ta, T1 or carcinoma in situ) diagnosed in 2004-2007 (n = 5839) in Sweden were investigated 5 years after diagnosis using a questionnaire. Differences in time to recurrence and progression were analysed in relation to age, gender, tumour stage and grade, intravesical treatment, healthcare region, and hospital volume of NMIBC patients (stratified in three equally large groups). Results. Local bladder recurrence and progression occurred in 50 and 9% of the patients, respectively. The rate of local recurrence was 56% in the southern healthcare region compared to 37% in the northern region. A multivariate Cox proportional hazards model, adjusting for age, gender, tumour stage and grade, intravesical treatment, healthcare region and hospital volume, showed that recurrence was associated with TaG2 and T1 disease, no intravesical treatment and treatment in the southern healthcare region, but indicated a lower risk of recurrence in the northern healthcare region. Adjusting for the same factors in a multivariate analysis suggested that increased relative risk of progression correlated with older age, higher tumour stage and grade, and diagnosis in the Uppsala/Örebro healthcare region, whereas such risk was decreased by intravesical treatment (relative risk 0.72, 95% confidence interval 0.55-0.93, p = 0.012). Conclusions. The incidence of NMIBC recurrence and progression was found to be high in Sweden, and important disparities in outcome related to care patterns appear to exist between different healthcare regions.},
  author       = {Liedberg, Fredrik and Hagberg, Oskar and Holmäng, Sten and Hosseini Aliabad, Abolfazl and Jancke, Georg and Ljungberg, Börje and Malmström, Per-Uno and Åberg, Hanna and Jahnson, Staffan},
  issn         = {2168-1813},
  language     = {eng},
  number       = {4},
  pages        = {290--295},
  publisher    = {Taylor & Francis},
  series       = {Scandinavian Journal of Urology2013-01-01+01:00},
  title        = {Local recurrence and progression of non-muscle-invasive bladder cancer in Sweden: a population-based follow-up study.},
  url          = {http://dx.doi.org/10.3109/21681805.2014.1000963},
  volume       = {49},
  year         = {2015},
}