Bladder Cancer Surgery Delay Linked to Poorer Survival-- Eric Metcalf
Wednesday, September 30, 2009
WEDNESDAY, Sept. 30 (HealthDay News) -- In patients with bladder cancer, less delay between transurethral tumor resection and cystectomy may improve the chances of survival, particularly in those with lower stage disease, according to research published in the October issue of the Journal of Urology.
Girish S. Kulkarni, M.D., of the University of Toronto, and colleagues analyzed data from 2,535 patients who underwent radical cystectomy for bladder cancer during a 12-year period. The median wait time between transurethral bladder resection and the cystectomy was 50 days.
The researchers found that longer wait times were associated with a poorer overall survival rate. The relative hazard of death associated with longer wait times was greater for low-stage than high-stage cancers. A 30-day increase in wait time was associated with a 12-percent higher hazard ratio for death four years after surgery for pT1 lesions, compared to 4 percent for pT4 lesions. The results suggest that 40 days is the ideal maximum wait time.
"Urologists can help minimize the delay from initial diagnosis to radical cystectomy by performing timely metastatic evaluations and demanding immediate, yet thorough, medical evaluations before surgery. Surgical schedules should be modified accordingly to minimize delay. Finally, from a broader public health perspective the most significant delay may be from the initial symptoms (e.g., gross hematuria) to urological referral," write the authors of an accompanying editorial.
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