1588 DIAGNOSIS TO CYSTECTOMY FOR MUSCLE-INVASIVE BLADDER CANCER HOW LONG IS SAFE?

You have accessJournal of UrologyBladder Cancer: Invasive II1 Apr 20121588 DIAGNOSIS TO CYSTECTOMY FOR MUSCLE-INVASIVE BLADDER CANCER HOW LONG IS SAFE? Eric Umbreit, Mark Shimko, Simon Kim, Robert Tarrell, Matthew Tollefson, Stephen Boorjian, and Igor Frank Eric UmbreitEric Umbreit Rochester, MN More articles by this author , Mark ShimkoMark Shimko Rochester, MN More articles by this author , Simon KimSimon Kim Rochester, MN More articles by this author , Robert TarrellRobert Tarrell Rochester, MN More articles by this author , Matthew TollefsonMatthew Tollefson Rochester, MN More articles by this author , Stephen BoorjianStephen Boorjian Rochester, MN More articles by this author , and Igor FrankIgor Frank Rochester, MN More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2012.02.1361AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Delays in therapy for muscle-invasive bladder cancer (MIBC) decrease patients risk of cancer-free survival by enabling further tumor invasion or systemic spread. The interval at which delayed treatment is associated with worse oncologic outcomes remains unknown. We aimed to evaluate the association of timing of radical cystectomy (RC) with oncologic outcomes in a cohort of patients with MIBC that underwent RC within three months of diagnosis. METHODS We examined 814 patients who underwent a RC at our institution between 1980 and 1998 within 90 days of their diagnosis for MIBC. The association of time interval from biopsy to radical cystectomy (RC) with tumor stage, cancer-specific (CSS), and recurrence-free (RFS) survival was analyzed using a cox proportional hazard model. An inflection point was noted at 35 days and patients were subsequently divided into 2 groups: (1) Cystectomy ≤ 35 days and (2) Cystectomy > 35 days. RESULTS The median time from pathologic diagnosis to RC was 20 days (range 0-90). Groups were well matched for age, sex, tobacco use, ECOG status, and TNM stage. Patients delayed > 35 days were more likely to have high-grade tumor (93 vs 86%, p=0.002). After adjusting for age, ECOG status, tumor grade, time to cystectomy was analyzed as a continuous variable and not associated with tumor stage (p=0.13), CSS (p=0.25) or RFS (p=0.66). Similarly, when time was analyzed as a binary variable, we found no association between CSS or RFS and time to cystectomy when analyzed as a categorical variable using the previously reported interval of 40 days and the deflection point noted in our own cohort of 35 days. CONCLUSIONS Within 90 days, longer delay to cystectomy is not associated with increased tumor stage or decreased CSS or RFS. While efforts should be made to perform radical cystectomy as early as possible following diagnosis, delay up to three months appears safe. © 2012 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 187Issue 4SApril 2012Page: e643 Advertisement Copyright & Permissions© 2012 by American Urological Association Education and Research, Inc.MetricsAuthor Information Eric Umbreit Rochester, MN More articles by this author Mark Shimko Rochester, MN More articles by this author Simon Kim Rochester, MN More articles by this author Robert Tarrell Rochester, MN More articles by this author Matthew Tollefson Rochester, MN More articles by this author Stephen Boorjian Rochester, MN More articles by this author Igor Frank Rochester, MN More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...