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학술연구/단체지원/교육 등 연구자 활동을 지속하도록 DBpia가 지원하고 있어요.
커뮤니티
연구자들이 자신의 연구와 전문성을 널리 알리고, 새로운 협력의 기회를 만들 수 있는 네트워킹 공간이에요.
논문 기본 정보
- 자료유형
- 학술저널
- 저자정보
- 발행연도
- 2020.1
- 수록면
- 390 - 396 (7page)
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Purpose: Cisplatin-based neoadjuvant chemotherapy (NAC) followed by radical cystectomy (RC) is standard of care for muscle-invasive bladder cancer (MIBC). However, NAC is used in less than 20% of patients with MIBC. Our goal is to investigate factors that contribute to underutilization NAC to facilitate more routine incorporation into clinical practice. Materials and Methods: We identified 5,915 patients diagnosed with cT2-T3N0M0 MIBC who underwent RC between 2004 and 2014 from the National Cancer Database. Univariate and multivariable models were created to identify variables associated with NAC utilization. Results: Only 18.8% of patients received NAC during the study period. On univariate analyses, NAC utilization was more likely at academic hospitals, US South and Midwest (p<0.05). Higher Charlson score was associated with decrease use of NAC (p<0.05). On multivariate analysis, treatment in academic hospitals (odds ratio [OR], 1.367; 95% confidence interval [CI], 1.186–1.576), in the Midwest (OR, 1.538; 95% CI, 1.268–1.977) and South (OR, 1.424; 95% CI, 1.139–1.781) were independently associated with NAC utilization. Older age (75 to 84 years old; OR, 0.532; 95% CI, 0.427–0.664) and higher Charlson score (OR, 0.607; 95% CI, 0.439–0.839) were associated with decreased NAC utilization. Sixty-eight percent of patients did not receive NAC because it was not planned and only 2.5% of patients had contraindications for NAC treatment. Conclusions: Our study demonstrates that NAC is underutilized. Decreased utilization of NAC was associated with older patients and higher Charlson score. This underutilization may be related to practice patterns as very few patients have true contraindications.
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등록된 정보가 없습니다.
참고문헌 (21)
참고문헌 신청
Siegel RL / 2017 / Cancer Statistics, 2017 / CA Cancer J Clin 67:7~30
Mertens LS / 2013 / Impact of (18) F-fluorodeoxyglucose (FDG)-positron-emission tomography/computed tomography (PET/CT) on management of patients with carcinoma invading bladder muscle / BJU Int 112:729~734
Wein AJ / 2015 / Campbellwalsh urology / Elsevier Health Sciences :2184~2204
Grossman HB / 2003 / Neoadjuvant chemotherapy plus cystectomy compared with cystectomy alone for locally advanced bladder cancer / N Engl J Med 349:859~866
Advanced Bladder Cancer (ABC) Meta-analysis Collaboration / 2005 / Neoadjuvant chemotherapy in invasive bladder cancer: update of a systematic review and meta-analysis of individual patient data advanced bladder cancer (ABC) meta-analysis collaboration / Eur Urol 48:202~205
Mertens LS / 2013 / Impact of (18) F-fluorodeoxyglucose (FDG)-positron-emission tomography/computed tomography (PET/CT) on management of patients with carcinoma invading bladder muscle / BJU Int 112:729~734
Wein AJ / 2015 / Campbellwalsh urology / Elsevier Health Sciences :2184~2204
Grossman HB / 2003 / Neoadjuvant chemotherapy plus cystectomy compared with cystectomy alone for locally advanced bladder cancer / N Engl J Med 349:859~866
Advanced Bladder Cancer (ABC) Meta-analysis Collaboration / 2005 / Neoadjuvant chemotherapy in invasive bladder cancer: update of a systematic review and meta-analysis of individual patient data advanced bladder cancer (ABC) meta-analysis collaboration / Eur Urol 48:202~205
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