Article ; Online: Management of Muscle-Invasive Bladder Cancer During a Pandemic: Impact of Treatment Delay on Survival Outcomes for Patients Treated With Definitive Concurrent Chemoradiotherapy.
2020 Volume 19, Issue 1, Page(s) 41–46.e1
Abstract: ... overall survival. We included patients with cT2-4N0M0 muscle-invasive bladder cancer from 2004 to 2015 ... Although these results are limited and require validation, short, strategic treatment delays during a pandemic can be ... Introduction: During the coronavirus disease 2019 (COVID-19) pandemic, providers and patients ...
| Abstract | 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. |
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| MeSH term(s) | Adolescent ; Adult ; Aged ; Aged, 80 and over ; COVID-19/epidemiology ; COVID-19/prevention & control ; COVID-19/transmission ; Chemoradiotherapy, Adjuvant/standards ; Chemoradiotherapy, Adjuvant/statistics & numerical data ; Cystectomy ; Decision Making, Shared ; Female ; Follow-Up Studies ; Humans ; Kaplan-Meier Estimate ; Male ; Middle Aged ; Neoplasm Invasiveness ; Pandemics/prevention & control ; Time Factors ; Time-to-Treatment/standards ; Time-to-Treatment/statistics & numerical data ; Treatment Outcome ; Urinary Bladder Neoplasms/mortality ; Urinary Bladder Neoplasms/pathology ; Urinary Bladder Neoplasms/therapy ; Young Adult |
| Keywords | covid19 |
| Language | English |
| Publishing date | 2020-06-22 |
| Publishing country | United States |
| Document type | Journal Article ; Observational Study |
| ZDB-ID | 2225121-2 |
| ISSN | 1938-0682 ; 1558-7673 |
| ISSN (online) | 1938-0682 |
| ISSN | 1558-7673 |
| DOI | 10.1016/j.clgc.2020.06.005 |
| Database | MEDical Literature Analysis and Retrieval System OnLINE |
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