umu.sePublikationer
Ändra sökning
RefereraExporteraLänk till posten
Permanent länk

Direktlänk
Referera
Referensformat
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Annat format
Fler format
Språk
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Annat språk
Fler språk
Utmatningsformat
  • html
  • text
  • asciidoc
  • rtf
Survival after radiotherapy versus radical cystectomy for primary muscle-invasive bladder cancer: A Swedish nationwide population-based cohort study
Umeå universitet, Medicinska fakulteten, Enheten för biobanksforskning.
Umeå universitet, Samhällsvetenskapliga fakulteten, Handelshögskolan vid Umeå universitet, Statistik.ORCID-id: 0000-0003-3187-1987
Visa övriga samt affilieringar
2019 (Engelska)Ingår i: Cancer Medicine, ISSN 2045-7634, E-ISSN 2045-7634, Vol. 8, nr 5, s. 2196-2204Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

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.

Ort, förlag, år, upplaga, sidor
John Wiley & Sons, 2019. Vol. 8, nr 5, s. 2196-2204
Nyckelord [en]
bladder cancer, muscle-invasive, radical cystectomy, radiotherapy, urothelial carcinoma
Nationell ämneskategori
Cancer och onkologi
Identifikatorer
URN: urn:nbn:se:umu:diva-158779DOI: 10.1002/cam4.2126ISI: 000469272500024PubMedID: 30938068OAI: oai:DiVA.org:umu-158779DiVA, id: diva2:1314312
Forskningsfinansiär
Cancerfonden, CAN 2013/472Tillgänglig från: 2019-05-08 Skapad: 2019-05-08 Senast uppdaterad: 2019-06-20Bibliografiskt granskad

Open Access i DiVA

fulltext(454 kB)28 nedladdningar
Filinformation
Filnamn FULLTEXT02.pdfFilstorlek 454 kBChecksumma SHA-512
7f6e79698fb3f23d3910ea5ad061fd5cee679f8a0d706952489008f58434efc668270406d364feeef1f7c4c92da4eacf6a90e2bdbfcf9666e07d6d619c0c4060
Typ fulltextMimetyp application/pdf

Övriga länkar

Förlagets fulltextPubMed

Personposter BETA

Häggström, Christelde Luna, XavierSöderkvist, Karin

Sök vidare i DiVA

Av författaren/redaktören
Häggström, Christelde Luna, XavierSöderkvist, Karin
Av organisationen
Enheten för biobanksforskningStatistikOnkologi
I samma tidskrift
Cancer Medicine
Cancer och onkologi

Sök vidare utanför DiVA

GoogleGoogle Scholar
Totalt: 36 nedladdningar
Antalet nedladdningar är summan av nedladdningar för alla fulltexter. Det kan inkludera t.ex tidigare versioner som nu inte längre är tillgängliga.

doi
pubmed
urn-nbn

Altmetricpoäng

doi
pubmed
urn-nbn
Totalt: 143 träffar
RefereraExporteraLänk till posten
Permanent länk

Direktlänk
Referera
Referensformat
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Annat format
Fler format
Språk
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Annat språk
Fler språk
Utmatningsformat
  • html
  • text
  • asciidoc
  • rtf