Objective: To determine whether a survival difference exists between patients with high grade (HG) cT1 urothelial cell carcinoma (UCC) receiving immediate radical cystectomy (IRC) as opposed to those choosing bladder-sparing therapy.
Patients And Methods: Between January 1990 and August 2010, 349 patients were retrospectively identified with a diagnosis of HG cT1 UCC of the bladder. Patients were divided into two groups: those who underwent IRC and those treated with conservative management (CM), consisting of transurethral resection of the bladder tumour (TURBT) and intravesical therapy. IRC was defined as surgery within 90 days of HG cT1 diagnosis with no intervening transurethral resection (TUR) or intravesical therapy (IVT). Trends in patient selection and cancer-specific survival (CSS) were analyzed over consecutive decades. The primary outcome was to compare CSS among patients during consecutive decades whereby management paradigms shifted from IRC to CM. The secondary outcome was to examine whether patient selection changed over time for each respective intervention.
Results: One hundred and thirteen patients underwent IRC and 236 had CM. From 1990 to 1999, only 90 patients were diagnosed with HG cT1 disease, and a majority of patients (n= 54) underwent IRC. From 2000 to 2010, only 23% (59/259) of the patients with HG cT1 underwent IRC. Despite 42.3% more patients successfully maintaining their bladder in the long-term, no difference in 5 year bladder CSS was noted between decades (77% vs 80% consecutively, P= 0.566). A subset analysis of risk factors for bladder cancer progression/recurrence demonstrated more patients with lymphovascular invasion (LVI) on TUR underwent IRC in the current era (13/59 (22.0%) vs 13/200 (6.5%), P < 0.001). These findings remain to be validated in prospective work at other institutions.
Conclusion: Conservative management strategies are a viable treatment option within a well selected subset of patients with HG cT1 UCC.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1111/j.1464-410X.2012.11116.x | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Developing a competency scale for selecting and assessing psychological peer counselors in ethnic-area colleges: a pilot study in Guizhou Province, China.
Front Psychol
December 2024
CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China.
Introduction: Psychological peer counselors play a crucial role in the mental health education of college students, especially in ethnic regions. The study zeroes in on developing a tool for selecting and assessing psychological peer counselors in ethnic-area colleges and universities, using Guizhou Province as a case study.
Materials And Methods: Focusing on psychological peer counselors in ethnic-area higher education institutions, this study amalgamates open-ended questionnaire surveys, interviews, and literature analysis to construct a competency characteristics questionnaire.
Monitoring Over Time of Pathological Complete Response to Neoadjuvant Chemotherapy in Breast Cancer Patients Through an Ensemble Vision Transformers-Based Model.
Cancer Med
December 2024
Laboratorio di Biostatistica e Bioinformatica, I.R.C.C.S. Istituto Tumori "Giovanni Paolo II", Bari, Italy.
Background: Morphological and vascular characteristics of breast cancer can change during neoadjuvant chemotherapy (NAC). Dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI)-acquired pre- and mid-treatment quantitatively capture information about tumor heterogeneity as potential earlier indicators of pathological complete response (pCR) to NAC in breast cancer.
Aims: This study aimed to develop an ensemble deep learning-based model, exploiting a Vision Transformer (ViT) architecture, which merges features automatically extracted from five segmented slices of both pre- and mid-treatment exams containing the maximum tumor area, to predict and monitor pCR to NAC.
Baseline Ga-68 PSMA PET-Derived Primary Tumor Parameters in Patients with Prostate Cancer and Their Association with Clinical Risk Stratification and Clinicopathologic Features.
World J Nucl Med
December 2024
Department of Nuclear Medicine, Atatürk Training and Research Hospital, İzmir Kâtip Çelebi University, Izmir, Türkiye.
This article evaluates whether parameters derived from the gallium-68-labeled prostate-specific membrane antigen ( Ga-PSMA) positron emission tomography/computed tomography (PET/CT) imaging studies of primary prostate cancer (PCa) lesions were associated with Gleason score (GS), D'Amico risk class, Candiolo nomograms, and the metastatic status of the disease. We retrospectively evaluated newly diagnosed PCa patients who underwent Ga-PSMA PET/CT before therapy. Age, baseline serum prostate-specific antigen (PSA), and metastatic status were recorded.
View Article and Find Full Text PDFPiloting of a Screen‑Triage‑Treat Surgical Approach Model for Management of Anal Cancer in Liberia.
Ann Glob Health
December 2024
Director of Global Women's Health, Mount Sinai Health System, New York, NY, USA.
While cancer is a leading cause of death worldwide, significant disparities exist in care access in low‑ and middle‑income countries (LMICs). In Liberia, screening and treatment for anal cancers remain limited, and are exacerbated among vulnerable groups, including men who have sex with men (MSM). Screen‑triage‑treat models for cancerous lesions have been successful in reducing cervical cancer mortality, but the feasibility of this approach has not been studied for anal cancers in a low‑resource context.
View Article and Find Full Text PDFThe association between neutrophil and lymphocyte to high-density lipoprotein cholesterol ratio and metabolic syndrome among Iranian population, finding from Bandare Kong cohort study.
Lipids Health Dis
November 2024
Endocrinology and Metabolism Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran.
Background: Metabolic Syndrome (MetS) is characterized by the co-occurrence of various metabolic risk factors, significantly increasing the risk of cardiovascular diseases (CVD) and type 2 diabetes (T2DM). This study investigates the potential of hematological indices, specifically the neutrophil to high-density lipoprotein cholesterol ratio (NHR) and lymphocyte to high-density lipoprotein cholesterol ratio (LHR), as predictors of MetS in a population from southern Iran.
Methods: Utilizing baseline data from the Bandare-Kong Non-Communicable Diseases (BKNCD) Cohort, part of the Prospective Epidemiological Research Studies in IrAN (PERSIAN), A total of 2,684 participants aged 35-70 years were analyzed.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!