ASCO GU 2017: Resection margins after radical cystectomy at academic versus community cancer centers. - Session Highlights
Orlando, Florida USA (UroToday.com) At this years genitourinary cancer symposium, the importance of high volume centers in care for radical cystectomy patients was re-inforced by looking at the impact of academic centers on positive margin rates. Positive margin resection correlates with worse overall survival following cystectomy. Data from 40,187 patients was included in this study which comprised of equal portions of patients treated at academic and community cancer centers. Academic centers had a small improvement in negative margin rates (90%) compared to community centers (88%) (p < 0.001). However after accounting for several variables such as neoadjuvant chemotherapy (which was used more in academic centers), sex, ethnicity, comorbidities, disease stage, tumor grade, and tumor size, and use of neoadjuvant chemotherapy, academic centers an significant decrease in positive margins (OR = 0.79, 95% CI 0.74-0.85). Furthermore, there was an improved survival seen at academic centers.
This study can be extrapolated to add to an existing body of knowledge on the importance of multidisciplinary care, the role of neoadjuvant chemotherapy and high volume centers in the care for bladder cancer. As more frequently these factors are present in academic centers.
Author: Kyle Scarberry
Written By: Michael J Metcalfe, MD, Fellow of Urologic Oncology Urology, MD Anderson Cancer Center, Houston TX Ashish M. Kamat, MD, MBBS, FACS, President, International Bladder Cancer Network Chair, Society of Immunotherapy for Cancer (SITC), BCTF, Director of Urologic Oncology Fellowship, Professor of Urology, Attending Surgeon, Division of Surgery, The University of Texas, MD Anderson Cancer Center, Houston TX