AUA 2013 - Session Highlights: Access to care predicts adequate pelvic lymph node dissection in patients undergoing radical cystectomy for muscle-invasive bladder cancer

SAN DIEGO, CA USA (UroToday.com) - Authors from Vanderbilt University analyzed patients with clinical T2 or T3 bladder cancer, from the National Cancer Data Base (NCDB) cancer registry and diagnosed between 1998 and 2010, to identify the likelihood of these patients receiving an adequate pelvic lymph node dissection (PLND) (≥ 10 lymph nodes) at the time of cystectomy.

They also investigated access-related predictors of adequate PLND in patients with muscle invasive bladder cancer.

Of the 78 43 patients, 46.8% patients had adequate PLND. The median number of nodes was 17 (interquartile range 13-26). On Univariate analyses, associations between adequate PLND and age, year of diagnosis, insurance status, metro/urban/rural, distance from hospital, geographic location, Charlson Comorbidity Index, and clinical stage were statistically significant (p < 0.05 for each). Given the evidence that adequate LND improves survival in patients with MIBC, according to this study, most patients (53.2%) who undergo radical cystectomy still do not receive adequate lymphadenectomy. On multivariate analysis, they identified median income, distance from hospital, and geographic location as access-related predictors of suboptimal PLND.

They concluded these findings suggest that targeted intervention can improve access to care and can potentially improve outcomes in patients with bladder cancer.

Presented by C.J. Stimson, Sanjay G. Patel, Harras B. Zaid, Samuel D. Kaffenberger, Matthew J. Resnick, Daniel A. Barocas, Michael S. Cookson, and Sam S. Chang at the American Urological Association (AUA) Annual Meeting - May 4 - 8, 2013 - San Diego Convention Center - San Diego, California USA


Reported for UroToday.com by Reza Mehrazin, MD

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