Abstract：
OBJECTIVE: Information on bladder cancer (BC) according to the risk scoring for recurrence or progression in a general population is scarce despite its clinical relevance. The objective was to describe the characteristics of incident BC in a general population, with a focus on the initial management of high-risk non-muscle invasive BC (HR-NMIBC).
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:
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:
摘要：
目的：在普通人群中，根据肿瘤亚型的膀胱癌（BC）信息很少，尽管它具有临床相关性。目的是描述一般人群中BC事件的特征，鉴于这些病例可能发生的不利演变，重点关注高风险非肌肉侵入性BC（HR-NMIBC）的初始管理。
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。
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。
