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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)
Linköping University, Department of Clinical and Experimental Medicine. Linköping University, Faculty of Medicine and Health Sciences.
Skane Univ Hosp, Sweden; Lund Univ, Sweden.
Uppsala Univ, Sweden; Umea Univ, Sweden.
Univ Gothenburg, Sweden; Sahlgrens Univ Hosp, Sweden.
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2019 (English)In: Scandinavian journal of urology, ISSN 2168-1805, E-ISSN 2168-1813Article in journal (Refereed) Epub ahead of print
Abstract [en]

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 amp;lt;= 60, 61-70, 71-80 and amp;gt;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 (amp;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. 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.

Place, publisher, year, edition, pages
TAYLOR & FRANCIS LTD , 2019.
Keywords [en]
Bladder cancer; lymph node metastasis; cohort study; management; outcome
National Category
Urology and Nephrology
Identifiers
URN: urn:nbn:se:liu:diva-162068DOI: 10.1080/21681805.2019.1681504ISI: 000493241700001PubMedID: 31663405OAI: oai:DiVA.org:liu-162068DiVA, id: diva2:1371334
Note

Funding Agencies|Swedish Cancer SocietySwedish Cancer Society [CAN 2016/470, CAN 2017/278]

Available from: 2019-11-19 Created: 2019-11-19 Last updated: 2019-11-19

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Abdul-Sattar Aljabery, FirasJahnson, Staffan
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Department of Clinical and Experimental MedicineFaculty of Medicine and Health SciencesDivision of Surgery, Orthopedics and OncologyDepartment of Urology in Östergötland
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Scandinavian journal of urology
Urology and Nephrology

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