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Impact of surgical ...
Impact of surgical experience on recurrence and progression after transurethral resection of bladder tumour in non-muscle-invasive bladder cancer
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- Jancke, Georg (author)
- Östergötlands Läns Landsting,Linköpings universitet,Avdelningen för kliniska vetenskaper,Hälsouniversitetet,Urologiska kliniken i Östergötland
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- Rosell, Johan (author)
- Östergötlands Läns Landsting,Linköpings universitet,Avdelningen för kliniska vetenskaper,Hälsouniversitetet,Regionalt cancercentrum
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- Jahnson, Staffan (author)
- Östergötlands Läns Landsting,Linköpings universitet,Avdelningen för kliniska vetenskaper,Hälsouniversitetet,Urologiska kliniken i Östergötland
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(creator_code:org_t)
- 2013-11-29
- 2014
- English.
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In: SCANDINAVIAN JOURNAL OF UROLOGY. - : Informa Healthcare. - 2168-1805 .- 2168-1813. ; 48:3, s. 276-283
- Related links:
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https://urn.kb.se/re...
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https://doi.org/10.3...
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Abstract
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- Introduction: To evaluate the impact of experience in transurethral resection of bladder tumor (TUR-BT) on recurrence and progression in primary Ta/T1 urinary bladder cancer.Methods: Clinical and pathological characteristics of patients with primary Ta/T1 urinary bladder cancer were recorded prospectively from 1992 to 2007 inclusive. Data on surgeons’ experience were categorized as follows: (a) experience by training status (residents or specialists); (b) number of TUR-BTs performed by each surgeon during the registration period, with cut-off levels at > 100, > 150, > 200, > median, and > third quartile of surgical volume; (c) lifetime high-volume surgeons (> 100 TUR-BTs). Hazard ratios (HRs) were estimated using Cox regression with 95% confidence intervals (CIs) in both univariate and multivariate analysis.Results: The analysis included 768 evaluable patients with a median follow-up of 60 months. Recurrence was observed in 478 patients (62%) and progression in 71 (9%). Surgery was performed by residents in 100 cases and specialists in 668, with recurrence in 75 (75%) and 403 (60%) patients, and progression in 9 (9%) and 62 (9%), respectively. Surgery performed by residents was statistically associated with recurrence (HR = 0.69, 95% CI = 0.54-0.89) but not progression (HR = 0.72, 95% CI = 0.35-1.48). Surgical volume (b and c) was not found to have a significant impact on recurrence or progression in any of the analyses at the chosen cut-offs.Conclusions: Surgical experience (specialist/resident) was a predictive factor for recurrence after TUR-BT for Ta/T1 bladder cancer. However, surgeon volume was not associated with recurrence at the chosen cut-off levels. Training programs, checklist
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kirurgi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Surgery (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Cancer och onkologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cancer and Oncology (hsv//eng)
Publication and Content Type
- ref (subject category)
- art (subject category)
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