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Search: onr:"swepub:oai:DiVA.org:uu-387973" > Survival after radi...

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  • Häggström, ChristelUppsala University,Umeå University,Umeå universitet,Uppsala universitet,Endokrinkirurgi,Umea Univ, Dept Biobank Res, Umea, Sweden,Enheten för biobanksforskning,Uppsala Univ, Sweden; Umea Univ, Sweden (author)

Survival after radiotherapy versus radical cystectomy for primary muscle-invasive bladder cancer : A Swedish nationwide population-based cohort study

  • Article/chapterEnglish2019

Publisher, publication year, extent ...

  • 2019-04
  • WILEY,2019
  • electronicrdacarrier

Numbers

  • LIBRIS-ID:oai:DiVA.org:uu-387973
  • https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-387973URI
  • https://doi.org/10.1002/cam4.2126DOI
  • https://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-158779URI
  • https://lup.lub.lu.se/record/cea12b58-f15a-4875-b7ae-ab84314a0082URI
  • http://kipublications.ki.se/Default.aspx?queryparsed=id:141034358URI
  • https://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-158578URI

Supplementary language notes

  • Language:English
  • Summary in:English

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  • Subject category:ref swepub-contenttype
  • Subject category:art swepub-publicationtype

Notes

  • Funding Agencies|Swedish Cancer Society [CAN 2013/472]
  • Background: Studies of survival comparing radical cystectomy (RC) and radiotherapy for muscle-invasive bladder cancer have provided inconsistent results and have methodological limitations. The aim of the study was to investigate risk of death after radiotherapy as compared to RC.Methods: We selected patients with muscle-invasive urothelial carcinoma without distant metastases, treated with radiotherapy or RC from 1997 to 2014 in the Bladder Cancer Data Base Sweden (BladderBaSe) and estimated absolute and relative risk of bladder cancer death and all-cause death. In a group of patients, theoretically eligible for a trial comparing radiotherapy and RC, we calculated risk difference in an instrumental variable analysis. We have not investigated chemoradiotherapy as this treatment was not used in the study time period.Results: The study included 3 309 patients, of those 17% were treated with radiotherapy and 83% with RC. Patients treated with radiotherapy were older, had more advanced comorbidity, and had a higher risk of death as compared to patients treated with RC (relative risks of 1.5-1.6). In the "trial population," all-cause death risk difference was 6 per 100 patients lower after radiotherapy at 5 years of follow-up, 95% confidence interval -41 to 29.Conclusion(s): Patient selection between the treatments make it difficult to evaluate results from conventionally adjusted and propensity-score matched survival analysis. When taking into account unmeasured confounding by instrumental variable analysis, no differences in survival was found between the treatments for a selected group of patients. Further clinical studies are needed to characterize this group of patients, which can serve as a basis for future comparison studies for treatment recommendations.

Subject headings and genre

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  • Garmo, HansKings Coll London, Sch Canc & Pharmaceut Sci, TOUR, London, England;Reg Canc Ctr Uppsala Orebro, Uppsala, Sweden,King's College London (author)
  • de Luna, XavierUmeå University,Umeå universitet,Statistik,Umea Univ, Dept Stat, USBE, Umea, Sweden(Swepub:umu)xade0001 (author)
  • Van Hemelrijck, MiekeKarolinska Institute,King's College London,Kings Coll London, Sch Canc & Pharmaceut Sci, TOUR, London, England;Karolinska Inst, Inst Environm Med, Stockholm, Sweden (author)
  • Söderkvist, KarinUmeå University,Umeå universitet,Onkologi,Umea Univ, Dept Radiat Sci, Oncol, Umea, Sweden(Swepub:umu)kansom97 (author)
  • Aljabery, FirasLinköpings universitet,Linköping University,Linkoping Univ, Div Urol, Dept Clin & Expt Med, Linkoping, Sweden,Institutionen för klinisk och experimentell medicin,Medicinska fakulteten,Region Östergötland, Urologiska kliniken i Östergötland(Swepub:liu)firab05 (author)
  • Ströck, VivekaSahlgrens Univ Hosp, Dept Urol, Gothenburg, Sweden,Sahlgrenska University Hospital (author)
  • Hosseini, AbolfazlKarolinska Univ Hosp, Dept Urol, Stockholm, Sweden,Karolinska University Hospital (author)
  • Gårdmark, TrulsKarolinska Institutet,Danderyd Hosp, Dept Clin Sci, Karolinska Inst, Stockholm, Sweden (author)
  • Malmström, Per-UnoUppsala University,Uppsala universitet,Urologkirurgi,Uppsala Univ, Sweden(Swepub:uu)perunoms (author)
  • Jahnson, StaffanLinköpings universitet,Linköping University,Linkoping Univ, Div Urol, Dept Clin & Expt Med, Linkoping, Sweden,Avdelningen för Kirurgi, Ortopedi och Onkologi,Medicinska fakulteten,Region Östergötland, Urologiska kliniken i Östergötland(Swepub:liu)staja74 (author)
  • Liedberg, FredrikLund University,Lunds universitet,Urologi - blåscancer, Malmö,Forskargrupper vid Lunds universitet,Urology - urothelial cancer, Malmö,Lund University Research Groups,Skåne University Hospital,Skane Univ Hosp, Dept Urol, Malmo, Sweden;Lund Univ, Dept Translat Med, Malmo, Sweden(Swepub:lu)urok-fli (author)
  • Holmberg, LarsUppsala University,Uppsala universitet,Endokrinkirurgi,Kings Coll London, Sch Canc & Pharmaceut Sci, TOUR, London, England,King's College London,Uppsala Univ, Sweden; Kings Coll London, England(Swepub:uu)larsholmb (author)
  • Uppsala universitetEndokrinkirurgi (creator_code:org_t)

Related titles

  • In:Cancer Medicine: WILEY8:5, s. 2196-22042045-7634

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