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Title: | Management of muscle-invasive bladder cancer in Victoria, 1990-1995. | Authors: | Syme R.;Giles G.G.;Thursfield V.;Millar J.L.;Frydenberg M. ;Toner G. | Institution: | (Millar) William Buckland Radiotherapy Centre, Alfred Hospital, Melbourne, Vic., Australia (Frydenberg) Department of Urology, Monash Medical Centre, Melbourne, Vic., Australia (Toner) Department of Medical Oncology, Peter MacCallum Cancer Institute, Melbourne, Vic., Australia (Syme, Thursfield, Giles) Cancer Epidemiology Centre, Cancer Council Victoria, Melbourne, Vic., Australia (Giles) Cancer Epidemiology Centre, Cancer Council Victoria, Carlton, Vic. 3053, Australia | Issue Date: | 17-Oct-2012 | Copyright year: | 2006 | Publisher: | Blackwell Publishing (550 Swanston Street, Carlton South VIC 3053, Australia) | Place of publication: | Australia | Publication information: | ANZ Journal of Surgery. 76 (3) (pp 113-119), 2006. Date of Publication: March 2006. | Abstract: | Background: The management and outcomes of muscle-invasive bladder cancer are described in this article. Method(s): A retrospective survey of medical practitioners involved in the management of bladder cancer was conducted. The survey obtained at least 5 years of follow-up data on all patients. The sample was taken from the public and private health sectors in Victoria. All were cases of muscle-invasive bladder cancer diagnosed between 1990 and 1995. The main outcome measures included reported management by staging, treatment and survival. Result(s): Completed questionnaires were returned for 743 (89.6%) of 829 cases. Of these, 523 (70.4%) were men, and the mean age was 72.7 years. More than 75% of the cases (560) presented with macroscopic haematuria. The majority (696, 94%) had transitional cell carcinoma. A variety of treatments were given in various sequences, with 231 cases (31.1%) having initial surveillance. Eventually, 303 cases (40.8%) proceeded to 'definitive' management with either radiotherapy (132, 17.8%) or cystectomy (171, 23.0%). In addition, chemotherapy was given to 254 patients (34.2%) at some time. Most patients (613, 82.5%) have subsequently died; 402 (54%) died from bladder cancer. Crude 5-year survival was 13.0%, and disease-specific survival was 27.7%. Multivariate analysis identified the following predictors of greater disease-specific survival: grade 1 or 2 histopathology (P = 0.0003), T2 primary (P < 0.0001), N0 disease (P = 0.04), M0 disease (P < 0.0001), radiation dose in BED10 >70 Gy and cystectomy (P < 0.0001). Conclusion(s): Muscle-invasive bladder cancer in Victoria typically occurs in elderly patients, and a notable proportion of these patients do not proceed onto 'definitive' treatment. Disease stage, cystectomy and the use of high doses of radiation are associated with better outcomes. Chemotherapy was given to approximately one-third of patients at some point in their disease management. Our data are similar to population-based data from North America, and provide a baseline against which potential changes in management of bladder cancer can be compared. © 2006 Royal Australasian College of Surgeons. | DOI: | http://monash.idm.oclc.org/login?url=http://dx.doi.org/10.1111/j.1445-2197.2006.03665.x | PubMed URL: | 16626343 [http://www.ncbi.nlm.nih.gov/pubmed/?term=16626343] | ISSN: | 1445-1433 | URI: | https://repository.monashhealth.org/monashhealthjspui/handle/1/32111 | Type: | Review | Subjects: | cancer survival cause of death controlled study cystectomy demography female follow up health survey hematuria/di [Diagnosis] hematuria/dt [Drug Therapy] hematuria/rt [Radiotherapy] hematuria/su [Surgery] histopathology major clinical study male medical record multivariate analysis *muscle cancer/di [Diagnosis] *muscle cancer/dt [Drug Therapy] *muscle cancer/rt [Radiotherapy] *muscle cancer/su [Surgery] outcomes research periodic medical examination physician public health service questionnaire radiation dose review transitional cell carcinoma/di [Diagnosis] transitional cell carcinoma/dt [Drug Therapy] transitional cell carcinoma/rt [Radiotherapy] transitional cell carcinoma/su [Surgery] BCG vaccine/dt [Drug Therapy] BCG vaccine/ve [Intravesical Drug Administration] cisplatin/cb [Drug Combination] cisplatin/dt [Drug Therapy] doxorubicin/cb [Drug Combination] doxorubicin/dt [Drug Therapy] methotrexate/cb [Drug Combination] methotrexate/dt [Drug Therapy] vinblastine/cb [Drug Combination] vinblastine/dt [Drug Therapy] human adult aged Australia *bladder cancer/di [Diagnosis] *bladder cancer/dt [Drug Therapy] *bladder cancer/rt [Radiotherapy] *bladder cancer/su [Surgery] cancer diagnosis cancer grading *cancer invasion/di [Diagnosis] *cancer invasion/dt [Drug Therapy] *cancer invasion/rt [Radiotherapy] *cancer invasion/su [Surgery] cancer radiotherapy cancer recurrence/dt [Drug Therapy] cancer recurrence/pc [Prevention] cancer registry cancer staging cancer survival cause of death controlled study cystectomy demography female follow up health survey hematuria / diagnosis / drug therapy / radiotherapy / surgery histopathology human major clinical study male medical record multivariate analysis *muscle cancer / *diagnosis / *drug therapy / *radiotherapy / *surgery outcomes research periodic medical examination physician public health service questionnaire Australia review transitional cell carcinoma / diagnosis / drug therapy / radiotherapy / surgery aged adult radiation dose *bladder cancer / *diagnosis / *drug therapy / *radiotherapy / *surgery cancer diagnosis cancer grading *cancer invasion / *diagnosis / *drug therapy / *radiotherapy / *surgery cancer radiotherapy cancer recurrence / drug therapy / prevention cancer registry cancer staging |
Type of Clinical Study or Trial: | Review article (e.g. literature review, narrative review) |
Appears in Collections: | Articles |
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