Partial cystectomy for urothelial carcinoma of the bladder: Practice patterns and outcomes in the general population
Bibliographic record
Abstract
INTRODUCTION: Partial cystectomy (PC) for urothelial carcinoma (UC) in selected patients may avoid the morbidity of radical cystectomy (RC). We describe use and outcomes of PC for UC in routine clinical practice. METHODS: All patients with urothelial carcinoma of the bladder (UCB) undergoing PC or RC in Ontario from 1994-2008 were identified using the Ontario Cancer Registry and linked electronic records. Pathology reports were reviewed. Variables associated with PC use were identified using logistic regression. Cox proportional hazards model identified factors affecting cancer-specific (CSS) and overall survival (OS). RESULTS: A total of 3320 patients underwent PC (n=181; 5%) or RC (n=3139; 95%) from 1994-2008. PC patients were older (36% 80+ years vs. 19%; p<0.001) and more likely to have organ-confined (<pT3) disease (54% vs. 36% RC; p<0.001). Two-thirds (67%) of PC patients did not undergo lymph node dissection (24% for RC; p<0.001). Factors associated with having PC included older age (odds ratio [OR] 1.55; 95% confidence interval [CI] 0.96-2.51 for 70+ years), moderate comorbidity (OR 1.95; 95% CI 1.13-3.37), and surgery outside of a comprehensive cancer centre (OR 1.44; 95% CI 1.03-2.01). Unadjusted five-year OS for PC and RC cases was 34% and 33%, respectively (p=0.455); CSS at five years was 43% and 37% (p=0.045). On adjusted analysis, PC was associated with comparable CSS (hazard ratio [HR] 0.87, 95% CI 0.70-1.09) and OS (HR 0.95, 95% CI 0.79-1.14) as RC. CONCLUSIONS: In routine clinical practice, PC is not common. A substantial proportion of patients treated with PC achieve long-term survival. PC remains a treatment option in selected patients with UCB.
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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 | 0.000 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 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 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".