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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, (författare)
Department of Clinical and Experimental Medicine, Division of Urology, Linköping University, Linköping, Sweden
Liedberg, Fredrik, (författare)
Department of Urology, Skåne University Hospital, Malmö, Sweden; Department of Translational Medicine, Lund University, Malmö, Sweden
Häggström, Christel, (författare)
Department of Surgical Sciences, Uppsala University, Uppsala, Sweden; Department of Biobank Research, Umeå University, Umeå, Sweden
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Ströck, Viveka, (författare)
Department of Urology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Department of Urology, Region Västra Götaland, Sahlgrenska University Hospital, Gothenburg, Sweden
Hosseini, Abolfazl, (författare)
Department of Pelvic Cancer, Karolinska University Hospital, Stockholm, Sweden
Gårdmark, Truls, (författare)
Department of Clinical Sciences, Danderyd Hospital, Karolinska Institute, Stockholm, Sweden
Sherif, Amir, (författare)
Department of Surgical and Perioperative Sciences, Urology and Andrology, Umeå University, Umeå, Sweden
Jerlström, Tomas, 1969- (författare)
Örebro universitet, Institutionen för medicinska vetenskaper, Region Örebro län, Department of Urology
Malmström, Per-Uno, (författare)
Department of Surgical Sciences, Uppsala University, Uppsala, Sweden
Holmberg, Lars, (författare)
Department of Surgical Sciences, Uppsala University, Uppsala, Sweden; School of Medicine, King´s College London, London, UK
Hagberg, Oskar, (författare)
Department of Translational Medicine, Lund University, Malmö, Sweden
Jahnson, Staffan, (författare)
Department of Clinical and Experimental Medicine, Division of Urology, Linköping University, Linköping, Sweden
Haggstrom, C. (författare)
Gardmark, T. (författare)
Jerlstrom, T. (författare)
Malmstrom, P. U. (författare)
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Örebro universitet Institutionen för medicinska vetenskaper. (creator_code:org_t)
Region Örebro län (creator_code:org_t)
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Göteborgs universitet Sahlgrenska akademin. Institutionen för kliniska vetenskaper, Avdelningen för urologi. 
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2019
Engelska.
Ingår i: Scandinavian journal of urology. - Informa Healthcare. - 2168-1805. ; 53:5, s. 332-338
  • Tidskriftsartikel (refereegranskat)
Abstract Ämnesord
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  • 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.

Ämnesord

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Urologi och njurmedicin (hsv//swe)
MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Urology and Nephrology (hsv//eng)
MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Cancer och onkologi (hsv//swe)
MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Cancer and Oncology (hsv//eng)

Nyckelord

Bladder cancer
cohort study
lymph node metastasis
management
outcome

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