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. 2013 Sep 1;119(17):3219-27.
doi: 10.1002/cncr.28147. Epub 2013 Jun 4.

Recurrence of high-risk bladder cancer: a population-based analysis

Karim Chamie  1 , Mark S Litwin, Jeffrey C Bassett, Timothy J Daskivich, Julie Lai, Jan M Hanley, Badrinath R Konety, Christopher S Saigal; Urologic Diseases in America Project
Affiliations

Recurrence of high-risk bladder cancer: a population-based analysis

Karim Chamie et al. Cancer. .

Abstract

Background: Patients with bladder cancer are apt to develop multiple recurrences that require intervention. The recurrence, progression, and bladder cancer-related mortality rates were examined in a cohort of individuals with high-grade non-muscle-invasive bladder cancer.

Methods: Using linked Surveillance, Epidemiology, and End Results (SEER)-Medicare data, subjects were identified who had a diagnosis of high-grade, non-muscle-invasive disease in 1992 to 2002 and who were followed until 2007. Multivariate competing-risks regression analyses were then used to examine recurrence, progression, and bladder cancer-related mortality rates.

Results: Of 7410 subjects, 2897 (39.1%) experienced a recurrence without progression, 2449 (33.0%) experienced disease progression, of whom 981 succumbed to bladder cancer. Using competing-risks regression analysis, the 10-year recurrence, progression, and bladder cancer-related mortality rates were found to be 74.3%, 33.3%, and 12.3%, respectively. Stage T1 was the only variable associated with a higher rate of recurrence. Women, black race, undifferentiated grade, and stage Tis and T1 were associated with a higher risk of progression and mortality. Advanced age (≥ 70) was associated with a higher risk of bladder cancer-related mortality.

Conclusions: Nearly three-fourths of patients diagnosed with high-risk bladder cancer will recur, progress, or die within 10 years of their diagnosis. Even though most patients do not die of bladder cancer, the vast majority endures the morbidity of recurrence and progression of their cancer. Increasing efforts should be made to offer patients intravesical therapy with the goal of minimizing the incidence of recurrences. Furthermore, the high recurrence rate seen during the first 2 years of diagnosis warrants an intense surveillance schedule.

Keywords: bladder cancer mortality; progression; quality of healthcare; recurrence; urinary bladder neoplasms.

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Figures

Figure 1
Figure 1
Schema of morbidity among our cohort of patients with high-grade non-muscle-invasive bladder cancer
Figure 2
Figure 2
Competing-risks regression analysis for recurrence, progression, and cause-specific mortality for bladder canser
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References

    1. Cancer Statistics 1984–2011 American Cancer Society Surveillance Research
    1. Fedeli U, Fedewa SA, Ward EM. Treatment of muscle invasive bladder cancer: evidence from the National Cancer Database, 2003 to 2007. The Journal of urology. 2011;185(1):72–8. - PubMed
    1. Gore JL, Lai J, Setodji CM, Litwin MS, Saigal CS. Mortality increases when radical cystectomy is delayed more than 12 weeks: results from a Surveillance, Epidemiology, and End Results-Medicare analysis. Cancer. 2009;115(5):988–96. - PMC - PubMed
    1. Herr HW, Dotan Z, Donat SM, Bajorin DF. Defining optimal therapy for muscle invasive bladder cancer. J Urol. 2007;177(2):437–43. - PubMed
    1. Madeb R, Golijanin D, Noyes K, et al. Treatment of nonmuscle invading bladder cancer: do physicians in the United States practice evidence based medicine? The use and economic implications of intravesical chemotherapy after transurethral resection of bladder tumors. Cancer. 2009;115(12):2660–70. - PMC - PubMed

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