1410 RADICAL CYSTECTOMY FOR CLINICALLY MUSCLE INVASIVE BLADDER CANCER: DOES PRIOR NON-INVASIVE DISEASE AFFECT CLINICAL OUTCOMES?
Bibliographic record
Abstract
You have accessJournal of UrologyBladder Cancer: Invasive I1 Apr 20121410 RADICAL CYSTECTOMY FOR CLINICALLY MUSCLE INVASIVE BLADDER CANCER: DOES PRIOR NON-INVASIVE DISEASE AFFECT CLINICAL OUTCOMES? Ahmed Kotb, Evan Kovac, Wassim Kassouf, Joe Chin, Yves Fradet, Jonathan Izawa, Eric Estey, Adrian Fairey, Ricardo Rendon, Ilias Cagiannos, Louis Lacombe, Jean-Baptiste Lattouf, David Bell, Darrel Drachenberg, and Armen Aprikian Ahmed KotbAhmed Kotb Montreal, Canada More articles by this author , Evan KovacEvan Kovac Montreal, Canada More articles by this author , Wassim KassoufWassim Kassouf Montreal, Canada More articles by this author , Joe ChinJoe Chin London, Canada More articles by this author , Yves FradetYves Fradet Quebec City, Canada More articles by this author , Jonathan IzawaJonathan Izawa London, Canada More articles by this author , Eric EsteyEric Estey Edmonton, Canada More articles by this author , Adrian FaireyAdrian Fairey Edmonton, Canada More articles by this author , Ricardo RendonRicardo Rendon Halifax, Canada More articles by this author , Ilias CagiannosIlias Cagiannos Ottawa, Canada More articles by this author , Louis LacombeLouis Lacombe Quebec City, Canada More articles by this author , Jean-Baptiste LattoufJean-Baptiste Lattouf Montreal, Canada More articles by this author , David BellDavid Bell Halifax, Canada More articles by this author , Darrel DrachenbergDarrel Drachenberg Winnipeg, Canada More articles by this author , and Armen AprikianArmen Aprikian Montreal, Canada More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2012.02.1861AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES To compare clinical and pathologic outcomes of radical cystectomy for muscle invasive bladder cancer in relation to prior history of non-invasive urothelial carcinoma. METHODS The Canadian Bladder Cancer Network was used to retrospectively analyze data from 1150 patients managed by radical cystectomy for urothelial carcinoma of the bladder. Patients with clinical stage T2 or more were included and divided into two groups: (Group 1) patients with prior history of non-invasive urothelial carcinoma (N=365), and (Group 2) patients with clinical muscle invasive cancer de novo (N=785). Variables analyzed included patient age, gender, pathologic stage, adjuvant chemotherapy, recurrence and mortality. RESULTS Both groups were nearly equal in mean age and gender distribution, with mean ages of 67.2 and 66.7 years, and 79.7% and 79.5%, respectively (P 0.4 and 0.9, respectively). The presence of preoperative hydronephrosis was 20.8% and 32.6% (P 0.0007) for groups 1 and 2, respectively. The rate of higher pathological stage (T3 or T4) was 36.3% and 58% (P <0.0001), positive lymph nodes was 20.1% and 28.8% (P 0.002) and lymphovascular invasion was 31.7% and 46.2% (P 0.0001) for groups 1 and 2, respectively. The rate of adjuvant chemotherapy was 15.5% and 23.3% (P 0.002) for groups 1 and 2, respectively. None of the sampled patients received neoadjuvant chemotherapy. The overall survival (OS) and disease-specific survival (DSS) rates at 5 years was 62% and 70% for group 1 and 51% and 60% for group 2, respectively, while at 10 years, OS and DSS was 46% and 66% for group 1 and 35% and 49% for group 2, respectively (P 0.0001 and 0.0002 respectively). Using multivariate analysis examining factors affecting recurrence and survival, we found that previous non-invasive bladder tumour history was associated with a significantly reduced risk of mortality and recurrence (Hazard ratio of 0.7 for all risks, P 0.0002). CONCLUSIONS Our retrospective study suggests that patients with non-invasive urothelial carcinoma of the bladder that progress to muscle-invasion and require radical cystectomy appear to have better pathologic and clinical outcome than patients presenting with clinical muscle invasive disease de novo. © 2012 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 187Issue 4SApril 2012Page: e573 Advertisement Copyright & Permissions© 2012 by American Urological Association Education and Research, Inc.MetricsAuthor Information Ahmed Kotb Montreal, Canada More articles by this author Evan Kovac Montreal, Canada More articles by this author Wassim Kassouf Montreal, Canada More articles by this author Joe Chin London, Canada More articles by this author Yves Fradet Quebec City, Canada More articles by this author Jonathan Izawa London, Canada More articles by this author Eric Estey Edmonton, Canada More articles by this author Adrian Fairey Edmonton, Canada More articles by this author Ricardo Rendon Halifax, Canada More articles by this author Ilias Cagiannos Ottawa, Canada More articles by this author Louis Lacombe Quebec City, Canada More articles by this author Jean-Baptiste Lattouf Montreal, Canada More articles by this author David Bell Halifax, Canada More articles by this author Darrel Drachenberg Winnipeg, Canada More articles by this author Armen Aprikian Montreal, Canada More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.011 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.002 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.028 | 0.005 |
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.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
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".