Follow-up care of 12 months of patients with bladder cancer in Spain : A multicenter prospective cohort study
Bonfill, X. (Xavier) (Institut d'Investigació Biomèdica Sant Pau)
Martinez-Zapata, Maria José (Institut d'Investigació Biomèdica Sant Pau)
Barrionuevo-Rosas, L. (Centro Cochrane Iberoamericano)
Vernooij, R.W.M. (Centro Cochrane Iberoamericano)
Sánchez, M.J. (Escuela Andaluza de Salud Pública. Instituto de Investigación Biosanitaria de Granada)
Morales-Suárez-Varela, M. (Universitat de València)
De La Cruz, J. (Hospital Universitario 12 de Octubre (Madrid))
Emparanza, J.I. (Hospital Universitario Donostia. BioDonostia)
Ferrer, M. (Institut Hospital del Mar d'Investigacions Mèdiques)
Pijoan, J.I. (Hospital Universitario de Cruces (Barakaldo, País Basc))
Palou, Juan (Institut d'Investigació Biomèdica Sant Pau)
Frances, Albert (Hospital Ntra. Sra. Del Mar)
Madrid, Eva (Centro Cochrane Iberoamericano)
Coscia, C. (Barts and the London School of Medicine and Dentistry. Queen Mary University London)
Zamora, J. (Instituto Ramón y Cajal de Investigación Sanitaria (Madrid))
Universitat Autònoma de Barcelona

Data:	2022
Resum:	The therapeutic approach of bladder cancer strongly determines its prognosis. We describe the treatments and outcomes for a Spanish cohort of patients with bladder cancer for the first 12 months after diagnosis and identify the factors that influenced the decision to undergo the treatment received. We conducted a multicenter, prospective, cohort study including primary bladder cancer patients during the first 12 months after diagnosis. The clinical outcomes were performance status (ECOG), adverse events and any cause of mortality. We stratified the analysis by factors that might influence the treatments received. We conducted univariate and multivariable logistic regression models to assess which patient and tumor characteristics were associated with receiving adjuvant treatment in the subgroup of noninvasive bladder cancer patients. In total, 314 patients were included (85% men; 53. 8% >70 years) in 7 tertiary Spanish hospitals; 82. 2% had a noninvasive urothelial bladder cancer (NMIBC). Patients received mostly surgery plus adjuvant therapy (67. 7%). BCG (32. 8% patients) was the most frequently administered adjuvant therapy, followed by intravesical chemotherapy (17. 8% patients) and radiotherapy (10. 8%). The variability of administered treatments among hospitals was low. Patients with NMIBC were more likely to receive adjuvant therapy if they had a higher educational level, some comorbidities and a high-grade tumor. The number of fully active patients (ECOG 0) significantly decreased during the first year of follow-up from 58% to 36 % (OR: 2. 41, 95%CI 1. 82-3. 20); at 12-month follow-up 10. 8% patients had died from any cause. In conclusion, most of the patients had a NMIBC. Surgery alone or plus adjuvant therapy were the commonest curative options of bladder cancer. BCG therapy was the adjuvant therapy most frequently administered. Higher educational level, presence of comorbidities and a high-grade tumor were associated with adjuvant therapy. Patient performance status was worsening over time. Almost 1 of 10 patients died during the first year of follow-up.
Ajuts:	Instituto de Salud Carlos III PS09/01204 Instituto de Salud Carlos III PS09/01619 Instituto de Salud Carlos III CP1120/00023
Drets:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, sempre que no sigui amb finalitats comercials, i sempre que es reconegui l'autoria de l'obra original.
Llengua:	Anglès
Document:	Article ; recerca ; Versió publicada
Matèria:	Bladder neoplasms ; Cohort study ; Male urogenital diseases ; Multicenter study ; Multivariable analysis
Publicat a:	Medicine, Vol. 101 Núm. 42 (October 2022) , p. E31175, ISSN 1536-5964

DOI: 10.1097/MD.0000000000031175
PMID: 36281169

8 p, 515.5 KB

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