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A delay in radical cystectomy of >3 months is not associated with a worse clinical outcome

2007· letter· en· W2040879241 on OpenAlexaff
Matthew E. Nielsen, Ganesh S. Palapattu, Pierre I. Karakiewicz, Yair Lotan, Patrick J. Bastian, Seth P. Lerner, Arthur I. Sagalowsky, Mark Schoenberg, Shahrokh F. Shariat

Bibliographic record

VenueBritish Journal of Urology · 2007
Typeletter
Languageen
FieldMedicine
TopicBladder and Urothelial Cancer Treatments
Canadian institutionsUniversité de Montréal
Fundersnot available
KeywordsCystectomyMedicineBladder cancerLogistic regressionPathologicalProstate cancerUrologyCancerInternal medicineSurgery

Abstract

fetched live from OpenAlex

The first three papers in this section relate to the use of radical cystectomy in bladder cancer, and each study describes issues which are uncommonly written about, but which are relevant and important to any urologist who manages such patients. There is also a paper from Cleveland describing the rare condition of neuroendocrine tumours in the kidney. This is a large series of cases, and the authors recommend awareness of the condition and the prudent use of immunohistochemical neuroendocrine markers. There are a further six papers on prostate cancer; two of them evaluate high‐grade prostatic intraepithelial neoplasia, taking different views on the subject. OBJECTIVE To examine the association between the interval from the last transurethral resection (TUR) to radical cystectomy (RC) and bladder cancer‐specific outcome, as the decision to proceed to RC for an individual patient is complex, and recent reports suggest an interval from diagnosis to RC of >3 months is associated with adverse outcomes. PATIENTS AND METHODS The records of 592 patients who had RC were reviewed; the interval from the last TUR was analysed as both a continuous and categorical variable (<3 vs ≥3 months). Logistic regression and survival analyses were used to evaluate the association between the interval to RC with pathological characteristics and clinical outcomes. RESULTS The mean ( sd ) actuarial cancer‐specific survival was 70.5 (2.3)% and 60.7 (3.2)% at 3 and 7 years, respectively. Overall, the median (range) time from TUR to RC was 1.8 (0.3–11.6) months. The interval to RC analysed as a continuous or categorical variable was not associated with extravesical or nodal disease, lymph node metastases, disease recurrence, overall or cancer‐specific survival. The results were similar in the subgroup of 320 patients (54%) with clinically muscle‐invasive disease. CONCLUSIONS These results suggest that a reasonable delay from the last TUR to RC is not independently associated with stage progression or with decreased recurrence‐free or disease‐specific survival. These findings might have important implications for trial design in the ongoing evaluation of neoadjuvant regimens. Nevertheless, we see no reason to advocate anything less than the timely consideration of definitive treatment for patients with high‐risk bladder cancer.

Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.

How this classification was reachedexpand

Full frame distilled prediction

Teacher imitation

Not calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.

metaresearch head score (Codex)0.001
metaresearch head score (Gemma)0.001
Version: codex-gemma-dda1882f352aValidation status: machine_predicted_unvalidated
Candidate categoriesMeta-epidemiology (narrow), Research integrity
Consensus categoriesResearch integrity
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Observational · Consensus signal: none
GenreCandidate signal: Empirical · Consensus signal: none
Teacher disagreement score0.240
Threshold uncertainty score1.000

Codex and Gemma teacher scores by category

CategoryCodexGemma
Metaresearch0.0010.001
Meta-epidemiology (narrow)0.0000.000
Meta-epidemiology (broad)0.0020.001
Bibliometrics0.0000.000
Science and technology studies0.0000.000
Scholarly communication0.0000.000
Open science0.0000.000
Research integrity0.0020.005
Insufficient payload (model declined to judge)0.0000.000

Machine scores (provisional)

The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.

Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.

Opus teacher head0.037
GPT teacher head0.331
Teacher spread0.294 · how far apart the two teachers sit on this one work
Validation statusscore_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it

Classification

machine, unvalidated

Machine predicted; both teacher heads agree on what is shown here.

Study designObservational
Domainnot available
GenreEmpirical

How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".

Quick stats

Citations66
Published2007
Admission routes1
Has abstractyes

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