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10.1016/j.clgc.2020.06.005

http://scihub22266oqcxt.onion/10.1016/j.clgc.2020.06.005
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suck abstract from ncbi


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pmid33187904
      Clin+Genitourin+Cancer 2021 ; 19 (1 ): 41-46.e1
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  • 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.
  • |*Decision Making, Shared [MESH]
  • |Adolescent [MESH]
  • |Adult [MESH]
  • |Aged [MESH]
  • |Aged, 80 and over [MESH]
  • |COVID-19/epidemiology/*prevention & control/transmission [MESH]
  • |Chemoradiotherapy, Adjuvant/*standards/statistics & numerical data [MESH]
  • |Cystectomy [MESH]
  • |Female [MESH]
  • |Follow-Up Studies [MESH]
  • |Humans [MESH]
  • |Kaplan-Meier Estimate [MESH]
  • |Male [MESH]
  • |Middle Aged [MESH]
  • |Neoplasm Invasiveness [MESH]
  • |Pandemics/prevention & control [MESH]
  • |Time Factors [MESH]
  • |Time-to-Treatment/*standards/statistics & numerical data [MESH]
  • |Treatment Outcome [MESH]
  • |Urinary Bladder Neoplasms/mortality/pathology/*therapy [MESH]


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