METHODS: BC incident in 2011-2012 recorded in a population-based cancer registry were studied. Data was extracted from medical files. NMIBC were classified according to potential risk for recurrence/progression. Individual and tumor characteristics of incident BC were described. Incidence, initial management and survival (12/31/2021) of HR-NMIBC were assessed.
RESULTS: Among 538 BC cases, 380 were NMIBC [119 low (22.1%), 163 intermediate (30.3%), 98 high (18.2%) risk] and 147 (27.3%) were MIBC. HR-NMIBC diagnostic and therapeutic management [imaging, re-TUR, multidisciplinary team meetings (MDT) assessment, specific treatment] revealed discrepancies with guidelines recommendations. Seventy-two out of 98 cases were assessed in an MDT with a median time from diagnosis of 18days [first quartile: 12-third quartile: 32]. Globally, treatment agreed with MDT decisions. Intravesical instillation was the most common treatment (n=56) but 27 HR-NMIBC did not receive specific treatment after TUR. Five and 10years overall survival was 52% [42-63] and 41% [31-51], respectively. Five years net survival was 63% [47-75].
CONCLUSIONS: Despite National cancer plans aiming to improve care giving and despite the severity of HR-NMIBC, guideline-recommended patterns of care were underused in this region. This may deserve attention to identify obstacles to guideline adoption to try to improve BC patient care and survival.
METHODS:
方法:研究了在基于人群的癌症登记处登记的2011-2012年的BC事件。数据是从医疗文件中提取的。根据复发/进展的潜在风险对NMIBC进行分类。描述了事件BC的个体和肿瘤特征。发病率,评估了HR-NMIBC的初始管理和生存率(2021年12月31日)。
结果:在538例BC病例中,380个是NMIBC(119个低(22.1%),163个中间体(30.3%),98例高风险(18.2%)和147例(27.3%)为MIBC。HR-NMIBC诊断和治疗管理(影像学,re-TUR,多学科小组会议(MDT)评估,具体治疗)与指南建议存在差异。在MDT期间对98例中的72例进行了评估,中位时间为18天[第一四分位数:12-第三四分位数:32]。治疗与全球MDT决定一致。膀胱内滴注是最常见的治疗方法(n=56),但27HR-NMIBC在TUR后未接受特定治疗。5年和10年总生存率分别为52%[42-63]和41%[31-51]。五年净生存率为63%[47-75]。
结论:尽管国家癌症计划旨在改善护理,尽管HR-NMIBC的严重程度,指南推荐的护理模式在该地区未得到充分利用.这可能值得关注,以确定指南采用的障碍,以试图改善BC患者的护理和生存率。