Peri-operative mortality and long-term survival after partial versus radical cystectomy for muscle invasive bladder cancer
Bibliographic record
Abstract
Objective: The aim of the study was to compare partial cystectomy (PC) and radical cystectomy (RC) with respect to 90-day mortality as well as long-term, all cause (ACM) and cancer specific mortality (CSM). Methods: Using the SEER-Medicare database 3913 patients with T2-T3 urothelial carcinoma of the urinary bladder (UCUB) who underwent either RC (n = 3419) or PC (n = 494) were identified. After propensity score matching to reduce potential treatment selection bias, 90-day mortality, ACM-free and CSM-free rates between patients treated with PC and RC were estimated. Multivariable regression models (MVA) addressed 90-day mortality as well as 5-years ACM and CSM. Results: After matching, 33% (n = 494) and 67% (n = 988) patients treated respectively with PC or RC remained. Median follow-up was 26 months. The 90-day mortality rate was 3.2% (n = 16) after PC and 8.1% (n = 80) after RC (P = 0.001). In MVA, PC vs. RC was associated with a lower 90-day mortality (P < 0.001). At 5 years the ACM-free survival rate was 38% after PC and 40% after RC (P = 0.3) and failed to differ in MVA (P = 0.9). At 5 years the CSM-free survival rate was 59% after PC and 62% after RC (P = 0.2) and also failed to differ in MVA (P = 0.57). The same results were observed after restriction to patients with pT2N0 UCUB. Conclusions: Relative to RC, PC is associated with lower short-term mortality and the same long-term ACM and CSM rates. These observations should encourage greater consideration to PC in those selected cases when this type of surgery may be applied.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot 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.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
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.
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 teacher head, 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".