Factors associated with utilization of neoadjuvant chemotherapy in charlson comorbidity zero non-metastatic muscle-invasive bladder cancer patients
ABSTRACT Background: Guideline-based best practice treatment for muscle invasive bladder cancer (MIBC) involves neoadjuvant chemotherapy followed by radical cystectomy (NACRC). Prior studies have shown that a minority of patients receive NACRC and older age and renal function are drivers of non-rec...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Sociedade Brasileira de Urologia
2021-07-01
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| Series: | International Brazilian Journal of Urology |
| Subjects: | |
| Online Access: | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1677-55382021000400803&tlng=en |
| _version_ | 1798020764075556864 |
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| author | Daniel Au Eugene K. Lee Taiye O. Popoola William P. Parker Jarron M. Saint Onge Shellie D. Ellis |
| author_facet | Daniel Au Eugene K. Lee Taiye O. Popoola William P. Parker Jarron M. Saint Onge Shellie D. Ellis |
| author_sort | Daniel Au |
| collection | DOAJ |
| description | ABSTRACT Background: Guideline-based best practice treatment for muscle invasive bladder cancer (MIBC) involves neoadjuvant chemotherapy followed by radical cystectomy (NACRC). Prior studies have shown that a minority of patients receive NACRC and older age and renal function are drivers of non-receipt of NACRC. This study investigates treatment rates and factors associated with not receiving NACRC in MIBC patients with lower comorbidity status most likely to be candidates for NACRC. Materials and Methods: Retrospective United States National Cancer Database analysis from 2006 to 2015 of MIBC patients with Charlson comorbidity index (CCI) of zero. Analysis of NACRC treatment trends in higher CCI patients was also performed. Results: 15.561 MIBC patients met inclusion criteria. 1.507 (9.7%) received NACRC within 9 months of diagnosis. NACRC increased over time (15.0% in 2015 compared to 3.6% in 2006). Higher NACRC was noted in females, cT3 or cT4 cancer, later year of diagnosis, and academic facility treatment. Lower utilization was noted for blacks and NACRC decreased with increasing age and CCI. Only 16.9% of patients aged 23-62 in the lowest age quartile with muscle invasive bladder cancer and CCI of 0 received NACRC. Conclusions: Although utilization is increasing, receipt of NACRC remains low even in populations most likely to be candidates. Further study should continue to elucidate barriers to utilization of NACRC. |
| first_indexed | 2024-04-11T17:02:57Z |
| format | Article |
| id | doaj.art-c67e18641caf4ed68deb0215fc22c3d2 |
| institution | Directory Open Access Journal |
| issn | 1677-6119 |
| language | English |
| last_indexed | 2024-04-11T17:02:57Z |
| publishDate | 2021-07-01 |
| publisher | Sociedade Brasileira de Urologia |
| record_format | Article |
| series | International Brazilian Journal of Urology |
| spelling | doaj.art-c67e18641caf4ed68deb0215fc22c3d22022-12-22T04:13:07ZengSociedade Brasileira de UrologiaInternational Brazilian Journal of Urology1677-61192021-07-0147480381810.1590/s1677-5538.ibju.2020.0594Factors associated with utilization of neoadjuvant chemotherapy in charlson comorbidity zero non-metastatic muscle-invasive bladder cancer patientsDaniel Auhttps://orcid.org/0000-0002-0223-5407Eugene K. LeeTaiye O. PopoolaWilliam P. ParkerJarron M. Saint OngeShellie D. EllisABSTRACT Background: Guideline-based best practice treatment for muscle invasive bladder cancer (MIBC) involves neoadjuvant chemotherapy followed by radical cystectomy (NACRC). Prior studies have shown that a minority of patients receive NACRC and older age and renal function are drivers of non-receipt of NACRC. This study investigates treatment rates and factors associated with not receiving NACRC in MIBC patients with lower comorbidity status most likely to be candidates for NACRC. Materials and Methods: Retrospective United States National Cancer Database analysis from 2006 to 2015 of MIBC patients with Charlson comorbidity index (CCI) of zero. Analysis of NACRC treatment trends in higher CCI patients was also performed. Results: 15.561 MIBC patients met inclusion criteria. 1.507 (9.7%) received NACRC within 9 months of diagnosis. NACRC increased over time (15.0% in 2015 compared to 3.6% in 2006). Higher NACRC was noted in females, cT3 or cT4 cancer, later year of diagnosis, and academic facility treatment. Lower utilization was noted for blacks and NACRC decreased with increasing age and CCI. Only 16.9% of patients aged 23-62 in the lowest age quartile with muscle invasive bladder cancer and CCI of 0 received NACRC. Conclusions: Although utilization is increasing, receipt of NACRC remains low even in populations most likely to be candidates. Further study should continue to elucidate barriers to utilization of NACRC.http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1677-55382021000400803&tlng=enUrinary Bladder NeoplasmCystectomyNeoadjuvant Therapy |
| spellingShingle | Daniel Au Eugene K. Lee Taiye O. Popoola William P. Parker Jarron M. Saint Onge Shellie D. Ellis Factors associated with utilization of neoadjuvant chemotherapy in charlson comorbidity zero non-metastatic muscle-invasive bladder cancer patients International Brazilian Journal of Urology Urinary Bladder Neoplasm Cystectomy Neoadjuvant Therapy |
| title | Factors associated with utilization of neoadjuvant chemotherapy in charlson comorbidity zero non-metastatic muscle-invasive bladder cancer patients |
| title_full | Factors associated with utilization of neoadjuvant chemotherapy in charlson comorbidity zero non-metastatic muscle-invasive bladder cancer patients |
| title_fullStr | Factors associated with utilization of neoadjuvant chemotherapy in charlson comorbidity zero non-metastatic muscle-invasive bladder cancer patients |
| title_full_unstemmed | Factors associated with utilization of neoadjuvant chemotherapy in charlson comorbidity zero non-metastatic muscle-invasive bladder cancer patients |
| title_short | Factors associated with utilization of neoadjuvant chemotherapy in charlson comorbidity zero non-metastatic muscle-invasive bladder cancer patients |
| title_sort | factors associated with utilization of neoadjuvant chemotherapy in charlson comorbidity zero non metastatic muscle invasive bladder cancer patients |
| topic | Urinary Bladder Neoplasm Cystectomy Neoadjuvant Therapy |
| url | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1677-55382021000400803&tlng=en |
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