Does prolonging the time to bladder cancer surgery affect long-term cancer control: a systematic review of the literature.
Notice bibliographique
Résumé
BACKGROUND: Prolonged surgical wait times have significant effects on a patient's psychological well-being and a negative impact on quality of life but the effect on long-term cancer control is controversial. We conducted a systematic review of the bladder cancer literature to examine the best available evidence addressing the following key questions: What is the reported time interval for bladder cancer patients from the decision to operate until the day of bladder cancer surgery? Are there recommendations/guidelines in the urological cancer literature and, if so, how do the Canadian times compare? Is there a known association between duration of wait time beyond the recommended standard and clinical outcome (i.e., recurrence-free survival, overall survival)? METHODS: A structured literature search PubMed, Embase, the Cochrane Database and Google Scholar from January 1965 to January 2006 was conducted for published studies and international guidelines/consensus documents that evaluated surgical wait times for bladder cancer. Data extracted from eligible studies included median time to bladder cancer surgery from diagnosis and key patient outcomes, such as survival rate or adjusted hazard ratios (HR). RESULTS: Eighteen studies evaluating wait times for bladder cancer surgery were identified, ten of which measured the association between prolonged waiting time and overall survival or tumor grade. Differences in study data availability, method of analysis and wait time definitions precluded statistical pooling of the findings. Median wait times from various points of patient contact ranged from 29 days (urologist consultation to transurethral resection) to 164 days (general practitioner referral to surgery). In the lone Canadian epidemiological study, which focused on all types of urological cancer, median wait time was 64 days from referral to surgery. This was in contrast to national and international guidelines, which recommended a maximum wait time between 2 and 4 weeks for all cancer surgeries. The association between surgical delay and overall survival remained controversial with some studies reporting a reduced overall survival in patients with prolonged delays, while others failed to find such associations. However, the three studies that measured the association between a delay of (3) 3 months and tumor grade reported that patients in the prolonged delay groups had an overall poorer tumor grade. CONCLUSIONS: In Canada, it appears that current wait times for urological surgeries, such as for bladder cancer, are beyond the threshold recommended by national and international expert bodies. Even though the association between surgical delay and overall survival remains inconclusive, there is evidence to suggest that prolonged delays are associated with an overall poorer tumor grade. To provide the necessary guidance and recommendations on these issues to the federal and provincial governments, the surgical wait times (SWAT) initiative was developed. Through a partnership of the key stakeholders, it is the vision of SWAT to ultimately improve the care and quality of life of bladder cancer patients and their families.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,010 | 0,059 |
| Méta-épidémiologie (sens strict) | 0,001 | 0,001 |
| Méta-épidémiologie (sens large) | 0,007 | 0,007 |
| Bibliométrie | 0,007 | 0,011 |
| Études des sciences et des technologies | 0,000 | 0,001 |
| Communication savante | 0,002 | 0,002 |
| Science ouverte | 0,002 | 0,001 |
| Intégrité de la recherche | 0,002 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,003 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».