485 MULTI-INSTITUTIONAL QUALITY OF CARE INITIATIVE FOR NON-METASTATIC MUSCLE-INVASIVE TRANSITIONAL CELL CARCINOMA OF THE BLADDER: PHASE 1
Notice bibliographique
Résumé
You have accessJournal of UrologyUrothelial Cancer: Medical & Surgical Therapy1 Apr 2011485 MULTI-INSTITUTIONAL QUALITY OF CARE INITIATIVE FOR NON-METASTATIC MUSCLE-INVASIVE TRANSITIONAL CELL CARCINOMA OF THE BLADDER: PHASE 1 Andrew Feifer, Jennifer Taylor, Marwan Shouery, Caroline Savage, Gary Steinberg, Walter M. Stadler, Joel DeCastro, Seth Lerner, Guilherme Godoy, Yair Lotan, Adam S. Feldman, Sarah Psutka, Wassim Kassouf, Faysal Yafi, Alexander Zlotta, Peter Black, Mark Schoenberg, Robert Grubb, Michael O'Donnell, Henry Rosevear, Andrew Stephenson, Amit Patel, Cheryl Lee, Alon Weizer, Dean Bajorin, Matthew Milowsky, Guido Dalbagni, Ethan Basch, and Bernard Bochner Andrew FeiferAndrew Feifer New York, NY More articles by this author , Jennifer TaylorJennifer Taylor New York, NY More articles by this author , Marwan ShoueryMarwan Shouery New York, NY More articles by this author , Caroline SavageCaroline Savage New York, NY More articles by this author , Gary SteinbergGary Steinberg Chicago, IL More articles by this author , Walter M. StadlerWalter M. Stadler Chicago, IL More articles by this author , Joel DeCastroJoel DeCastro Chicago, IL More articles by this author , Seth LernerSeth Lerner Houston, TX More articles by this author , Guilherme GodoyGuilherme Godoy Houston, TX More articles by this author , Yair LotanYair Lotan Dallas, TX More articles by this author , Adam S. FeldmanAdam S. Feldman Boston, MA More articles by this author , Sarah PsutkaSarah Psutka Boston, MA More articles by this author , Wassim KassoufWassim Kassouf Montreal, Canada More articles by this author , Faysal YafiFaysal Yafi Montreal, Canada More articles by this author , Alexander ZlottaAlexander Zlotta Toronto, Canada More articles by this author , Peter BlackPeter Black Vancouver, Canada More articles by this author , Mark SchoenbergMark Schoenberg Baltimore, MD More articles by this author , Robert GrubbRobert Grubb St. Louis, MO More articles by this author , Michael O'DonnellMichael O'Donnell Iowa City, United Kingdom More articles by this author , Henry RosevearHenry Rosevear Iowa City, IA More articles by this author , Andrew StephensonAndrew Stephenson Cleveland, OH More articles by this author , Amit PatelAmit Patel Cleveland, OH More articles by this author , Cheryl LeeCheryl Lee Ann Arbor, MI More articles by this author , Alon WeizerAlon Weizer Ann Arbor, MI More articles by this author , Dean BajorinDean Bajorin New York, NY More articles by this author , Matthew MilowskyMatthew Milowsky New York, NY More articles by this author , Guido DalbagniGuido Dalbagni New York, NY More articles by this author , Ethan BaschEthan Basch New York, NY More articles by this author , and Bernard BochnerBernard Bochner New York, NY More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2011.02.580AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Evidence supports a multimodality treatment approach for muscle invasive bladder cancer [MIBC] with the strongest evidence (level 1) existing for cisplatin based neoadjuvant chemotherapy. Although reflected in guidelines for the management of MIBC, little is known about the variation of actual practice patterns among academic institutions. We thus evaluated treatment variation among 14 academic centers in the management of patients with MIBC. METHODS Retrospective data were collected for centralized analysis from all institutions. All patients that underwent radical cystectomy for clinical T2-4 N0M0MIBC from 2003−2008 were eligible for inclusion. Specific endpoints for analysis included: rates of neoadjuvant and adjuvant therapy, cisplatin utilization, number of cycles and rates of pelvic lymphadenectomy. RESULTS 14 institutions participated and data on 4541 patients who met inclusion criteria were tabulated. Overall 34% of patients received perioperative chemotherapy. The overall use of neoadjuvant and adjuvant therapy was 12% and 22%, respectively. In a subset analysis of those patients with specific chemotherapy agent information provided (n=3120), 59% of patients managed with perioperative chemotherapy received a cisplatin-based regimen. Of those who received treatment in the neoadjuvant setting, cisplatin was received in 65% of cases (supported by level 1 evidence). 80% of patients who received perioperative chemotherapy received at least 3 cycles. At radical cystectomy 95% of patients received a bilateral PLND. CONCLUSIONS In this cohort of academic North American centers, 66% of T2-4 N0M0MIBC patients undergoing radical cystectomy did not receive perioperative chemotherapy. Only 12% of patients received neoadjuvant chemotherapy, and 35% of those patients received a non-cisplatin based regimen. Despite level 1 evidence that cisplatin based neoadjuvant chemotherapy is associated with a survival advantage, only a small percentage of eligible patients undergoing radical cystectomy for muscle invasive, resectable disease receive combined treatment. Further study is needed to clarify specific reasons for the treatment variation observed in academic centers. © 2011 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 185Issue 4SApril 2011Page: e198 Advertisement Copyright & Permissions© 2011 by American Urological Association Education and Research, Inc.MetricsAuthor Information Andrew Feifer New York, NY More articles by this author Jennifer Taylor New York, NY More articles by this author Marwan Shouery New York, NY More articles by this author Caroline Savage New York, NY More articles by this author Gary Steinberg Chicago, IL More articles by this author Walter M. Stadler Chicago, IL More articles by this author Joel DeCastro Chicago, IL More articles by this author Seth Lerner Houston, TX More articles by this author Guilherme Godoy Houston, TX More articles by this author Yair Lotan Dallas, TX More articles by this author Adam S. Feldman Boston, MA More articles by this author Sarah Psutka Boston, MA More articles by this author Wassim Kassouf Montreal, Canada More articles by this author Faysal Yafi Montreal, Canada More articles by this author Alexander Zlotta Toronto, Canada More articles by this author Peter Black Vancouver, Canada More articles by this author Mark Schoenberg Baltimore, MD More articles by this author Robert Grubb St. Louis, MO More articles by this author Michael O'Donnell Iowa City, United Kingdom More articles by this author Henry Rosevear Iowa City, IA More articles by this author Andrew Stephenson Cleveland, OH More articles by this author Amit Patel Cleveland, OH More articles by this author Cheryl Lee Ann Arbor, MI More articles by this author Alon Weizer Ann Arbor, MI More articles by this author Dean Bajorin New York, NY More articles by this author Matthew Milowsky New York, NY More articles by this author Guido Dalbagni New York, NY More articles by this author Ethan Basch New York, NY More articles by this author Bernard Bochner New York, NY More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...
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 | 0,012 | 0,009 |
| Méta-épidémiologie (sens strict) | 0,001 | 0,000 |
| Méta-épidémiologie (sens large) | 0,001 | 0,001 |
| Bibliométrie | 0,001 | 0,001 |
| Études des sciences et des technologies | 0,001 | 0,001 |
| Communication savante | 0,003 | 0,001 |
| Science ouverte | 0,002 | 0,003 |
| Intégrité de la recherche | 0,002 | 0,002 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,036 | 0,007 |
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 ».