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.jpg): Failed to open stream: No such file or directory in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 117 Clin+Genitourin+Cancer
2021 ; 19
(1
): 41-46.e1
Nephropedia Template TP
gab.com Text
Twit Text FOAVip
Twit Text #
English Wikipedia
Management of Muscle-Invasive Bladder Cancer During a Pandemic: Impact of
Treatment Delay on Survival Outcomes for Patients Treated With Definitive
Concurrent Chemoradiotherapy
#MMPMID33187904
Fischer-Valuck BW
; Michalski JM
; Harton JG
; Birtle A
; Christodouleas JP
; Efstathiou JA
; Arora VK
; Kim EH
; Knoche EM
; Pachynski RK
; Picus J
; Rao YJ
; Reimers M
; Roth BJ
; Sargos P
; Smith ZL
; Zaghloul MS
; Gay HA
; Patel SA
; Baumann BC
Clin Genitourin Cancer
2021[Feb]; 19
(1
): 41-46.e1
PMID33187904
show ga
INTRODUCTION: During the coronavirus disease 2019 (COVID-19) pandemic, providers
and patients must engage in shared decision making to ensure that the benefit of
early intervention for muscle-invasive bladder cancer exceeds the risk of
contracting COVID-19 in the clinical setting. It is unknown whether treatment
delays for patients eligible for curative chemoradiation (CRT) compromise
long-term outcomes. PATIENTS AND METHODS: We used the National Cancer Data Base
to investigate whether there is an association between a ? 90-day delay from
transurethral resection of bladder tumor (TURBT) in initiating CRT and overall
survival. We included patients with cT2-4N0M0 muscle-invasive bladder cancer from
2004 to 2015 who underwent TURBT and curative-intent concurrent CRT. Patients
were grouped on the basis of timing of CRT: ? 89 days after TURBT (earlier) vs. ?
90 and < 180 days after TURBT (delayed). RESULTS: A total of 1387 (87.5%)
received earlier CRT (median, 45 days after TURBT; interquartile range, 34-59
days), and 197 (12.5%) received delayed CRT (median, 111 days after TURBT;
interquartile range, 98-130 days). Median overall survival was 29.0 months (95%
CI, 26.0-32.0) versus 27.0 months (95% CI, 19.75-34.24) for earlier and delayed
CRT (P = .94). On multivariable analysis, delayed CRT was not associated with an
overall survival difference (hazard ratio, 1.05; 95% CI, 0.87-1.27; P = .60).
CONCLUSION: Although these results are limited and require validation, short,
strategic treatment delays during a pandemic can be considered on the basis of
clinician judgment.