Estimating the optimal perioperative chemotherapy utilization rate for muscle ‐invasive bladder cancer
We report a benchmarking approach to estimate the optimal rate of perioperative CT for muscle ‐invasive bladder cancer (MIBC).MethodsThe Ontario Cancer Registry and linked treated records were used to identify neoadjuvant and adjuvant CT rates among patients with MIBC during 2004 ‐2013. Monte Carlo simulation was used to estimate the proportion of observed rate variation that could be due to chance alone. The criterion‐based benchmarking approach was used to explore whether social and health‐system factors were associated with CT rates. We also used the “pared‐mean ” approach to identify a benchmark population of hospitals with the highest treatment rates. Hospital CT rates were adjusted for case mix and simulated using a multi‐level multivariable model and a parametric bootstrapping approach.ResultsThe study population included 2581 patients; perioperative CT was delivered to 31% (798/2581). Multivariate analysis showed that treatment was strongly associated with patient socioeconomic status and hospital teaching status. The benchmark rate was 36%. Unadjusted CT rates were significantly different across hospitals (range 0% ‐52%,P
Abstract OBJECTIVES: Overexpression of aurora kinase A (AURKA) confers a poor prognosis in patients with urothelial carcinoma of the bladder. The prognostic value of high aurora kinase B (AURKB) expression in local bladder cancer is not well defined, and whether the prognostic value of either AURKA or AURKB is affected by the use of chemotherapy is unknown. We sought to characterize the impact of high AURKA and AURKB expression on clinical outcome in patients with muscle-invasive bladder cancer (MIBC) who received neoadjuvant chemotherapy (NAC). MATERIALS AND METHODS: Immunohistochemistry for AURKA and AURKB ...
"Watch and Wait" for complete clinical response after neoadjuvant chemoradiotherapy for rectal cancer. Minerva Chir. 2019 Sep 30;: Authors: Peacock O, Chang GJ Abstract The management of rectal cancer has evolved substantially over recent decades, becoming increasingly complex. This was once a disease associated with high mortality and limited treatment options that typically necessitated a permanent colostomy, has now become a model for multidisciplinary evaluation, treatment and surgical advancement. Despite advances in the rates of total mesorectal excision, decreased local recurrence and ...
ConclusionsThe results demonstrate that robotic-assisted TME for patients with rectal cancer after neoadjuvant CCRT (concurrent chemoradiotherapy) is effective and for patient with tumor invaded to bladder, prostate or uterus, neoadjuvant chemotherapy is a safe and effective way for organ-preserving instead of salvage surgery.Legal entity responsible for the studyThe authors.FundingHas not received any funding.DisclosureAll authors have declared no conflicts of interest.
Conclusion: Neoadjuvant chemotherapy utilization continues to slowly increase in patients with MIBC. Patients with variant histology lag behind in terms of receiving NAC but appear to derive as much benefit as patients with pure urothelial cell bladder cancer.
ConclusionsWe propose a set of QIs for both NMIBC and MIBC based on established clinical guidelines and the available literature. Measurement of these QIs could aid in improvement and benchmarking of optimal care of bladder cancer.Patient summaryAfter a systematic review of existing guidelines and literature, a panel of experts has recommended a set of quality indicators that can help providers and patients measure and strive towards optimal outcomes for bladder cancer care.
Conditions: Bladder Cancer; Chemotherapy Effect Intervention: Combination Product: neoadjuvant chemotherapy with cisplatine Sponsors: University Hospital, Rouen; Institut Curie; APHP Recruiting
CONCLUSIONS: According to our analysis, NSRH surgery after NAC via balloon occluded arterial infusion brings beneficial results to patients with bulky IB2 to IIB cervical cancers. PMID: 31497250 [PubMed]