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Management and outcome of muscle-invasive bladder cancer with clinical lymph node metastases. A nationwide population-based study in the bladder cancer data base Sweden (BladderBaSe)

Aljabery, Firas ; Liedberg, Fredrik LU ; Häggström, Christel ; Ströck, Viveka ; Hosseini, Abolfazl ; Gårdmark, Truls ; Sherif, Amir ; Jerlström, Tomas ; Malmström, Per Uno and Holmberg, Lars , et al. (2019) In Scandinavian Journal of Urology
Abstract

Purpose: To investigate the clinical management and outcome of patients with muscle-invasive bladder cancer with clinical lymph node involvement, using longitudinal nationwide population-based data. 

Methods: In the Bladder Cancer Data Base Sweden (BladderBaSe), treatment and survival in patients with urinary bladder cancer clinical stage T2–T4 N + M0 diagnosed between 1997 and 2014 was investigated. Patients´ characteristics were studied in relation to TNM classification, curative or palliative treatment, cancer-specific (CSS) and overall survival (OS). Age at diagnosis was categorised as ≤60, 61–70, 71–80 and >80 years, and time periods were stratified as follows: 1997–2001, 2002–2005, 2006–2010 and 2011–2014. 

Results:... (More)

Purpose: To investigate the clinical management and outcome of patients with muscle-invasive bladder cancer with clinical lymph node involvement, using longitudinal nationwide population-based data. 

Methods: In the Bladder Cancer Data Base Sweden (BladderBaSe), treatment and survival in patients with urinary bladder cancer clinical stage T2–T4 N + M0 diagnosed between 1997 and 2014 was investigated. Patients´ characteristics were studied in relation to TNM classification, curative or palliative treatment, cancer-specific (CSS) and overall survival (OS). Age at diagnosis was categorised as ≤60, 61–70, 71–80 and >80 years, and time periods were stratified as follows: 1997–2001, 2002–2005, 2006–2010 and 2011–2014. 

Results: There were 786 patients (72% males) with a median age of 71 years (interquartile range = 64–79 years). The proportion of patients with high comorbidity increased over time. Despite similar low comorbidity, curative treatment was given to 44% and to 70% of those in older (>70 years) and younger age groups, respectively. Curative treatment decreased over time, but chemotherapy and cystectomy increased to 25% during the last time period. Patients with curative treatment had better survival compared to those with palliative treatment, both regarding CSS and OS in the whole cohort and in all age groups. 

Conclusions: The low proportion of older patients undergoing treatment with curative intent, despite no or limited comorbidity, indicates missed chances of treatment with curative intent. The reasons for an overall decrease in curative treatment over time need to be analysed and the challenge of coping with an increasing proportion of node-positive patients with clinically significant comorbidity needs to be met.

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organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Bladder cancer, cohort study, lymph node metastasis, management, outcome
in
Scandinavian Journal of Urology
publisher
Taylor & Francis
external identifiers
  • pmid:31663405
  • scopus:85074796025
ISSN
2168-1805
DOI
10.1080/21681805.2019.1681504
language
English
LU publication?
yes
id
799c1672-08bb-43f1-926a-24bca5eedc74
date added to LUP
2019-12-09 11:46:46
date last changed
2021-03-31 01:23:19
@article{799c1672-08bb-43f1-926a-24bca5eedc74,
  abstract     = {<p>Purpose: To investigate the clinical management and outcome of patients with muscle-invasive bladder cancer with clinical lymph node involvement, using longitudinal nationwide population-based data. </p><p>Methods: In the Bladder Cancer Data Base Sweden (BladderBaSe), treatment and survival in patients with urinary bladder cancer clinical stage T2–T4 N + M0 diagnosed between 1997 and 2014 was investigated. Patients´ characteristics were studied in relation to TNM classification, curative or palliative treatment, cancer-specific (CSS) and overall survival (OS). Age at diagnosis was categorised as ≤60, 61–70, 71–80 and &gt;80 years, and time periods were stratified as follows: 1997–2001, 2002–2005, 2006–2010 and 2011–2014. </p><p>Results: There were 786 patients (72% males) with a median age of 71 years (interquartile range = 64–79 years). The proportion of patients with high comorbidity increased over time. Despite similar low comorbidity, curative treatment was given to 44% and to 70% of those in older (&gt;70 years) and younger age groups, respectively. Curative treatment decreased over time, but chemotherapy and cystectomy increased to 25% during the last time period. Patients with curative treatment had better survival compared to those with palliative treatment, both regarding CSS and OS in the whole cohort and in all age groups. </p><p>Conclusions: The low proportion of older patients undergoing treatment with curative intent, despite no or limited comorbidity, indicates missed chances of treatment with curative intent. The reasons for an overall decrease in curative treatment over time need to be analysed and the challenge of coping with an increasing proportion of node-positive patients with clinically significant comorbidity needs to be met.</p>},
  author       = {Aljabery, Firas and Liedberg, Fredrik and Häggström, Christel and Ströck, Viveka and Hosseini, Abolfazl and Gårdmark, Truls and Sherif, Amir and Jerlström, Tomas and Malmström, Per Uno and Holmberg, Lars and Hagberg, Oskar and Jahnson, Staffan},
  issn         = {2168-1805},
  language     = {eng},
  month        = {10},
  publisher    = {Taylor & Francis},
  series       = {Scandinavian Journal of Urology},
  title        = {Management and outcome of muscle-invasive bladder cancer with clinical lymph node metastases. A nationwide population-based study in the bladder cancer data base Sweden (BladderBaSe)},
  url          = {http://dx.doi.org/10.1080/21681805.2019.1681504},
  doi          = {10.1080/21681805.2019.1681504},
  year         = {2019},
}