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Second-look resection for primary stage T1 bladder cancer: a population-based study
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2017 (English)In: Scandinavian journal of urology, ISSN 2168-1805, E-ISSN 2168-1813, Vol. 51, no 4, 301-307 p.Article in journal (Refereed) Published
Abstract [en]

OBJECTIVE: This study aimed to evaluate the use of second-look resection (SLR) in stage T1 bladder cancer (BC) in a population-based Swedish cohort.

MATERIALS AND METHODS: All patients diagnosed with stage T1 BC in 2008-2009 were identified in the Swedish National Registry for Urinary Bladder Cancer. Registry data on TNM stage, grade, primary treatment and pathological reports from the SLR performed within 8 weeks of the primary transurethral resection were validated against patient charts. The endpoint was cancer-specific survival (CSS).

RESULTS: In total, 903 patients with a mean age of 74 years (range 28-99 years) were included. SLR was performed in 501 patients (55%), who had the following stages at SLR: 172 (35%) T0, 83 (17%) Ta/Tis, 210 (43%) T1 and 26 (5%) T2-4. The use of SLR varied from 18% to 77% in the six healthcare regions. Multiple adjuvant intravesical instillations were given to 420 patients (47%). SLR was associated with intravesical instillations, age younger than 74 years, discussion at multidisciplinary tumour conference, G3 tumour and treatment at high-volume hospitals. Patients undergoing SLR had a lower risk of dying from BC (hazard ratio 0.62, 95% confidence interval 0.45-0.84, p < .0022). Five-year CSS rates were as follows, in patients with the indicated tumours at SLR (p = .001): 82% in those with T1, 90% in T0, 90% in Ta/Tis and 56% in T2-4.

CONCLUSIONS: There are large geographical differences in the use of SLR in stage T1 BC in Sweden, which are presumably related to local treatment traditions. Patients treated with SLR have a high rate of residual tumour but lower age, which suggests that a selection bias affects CSS.

Place, publisher, year, edition, pages
2017. Vol. 51, no 4, 301-307 p.
Keyword [en]
Bladder cancer, cancer-specific survival, population-based, second-look resection, stage T1
National Category
Urology and Nephrology
Identifiers
URN: urn:nbn:se:umu:diva-134470DOI: 10.1080/21681805.2017.1303846ISI: 000405483400012PubMedID: 28398113OAI: oai:DiVA.org:umu-134470DiVA: diva2:1093775
Available from: 2017-05-08 Created: 2017-05-08 Last updated: 2017-08-18Bibliographically approved

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CiteExportLink to record
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