Bibliographic record
Abstract
Introduction and Objective: Bladder cancer often recurs after surgical intervention and there is debate with regards to the optimal follow-up strategies.We sought to review our data on the recurrence patterns following radical cystectomy with the aim to establish appropriate surveillance protocols for patients with localized and locally advanced bladder cancer.Methods: We collected and pooled a database of 2,287 patients who have undergone radical cystectomy for carcinoma of the bladder between 1993 and 2008 in 8 different academic centres across Canada.Of these, 1,890 patients had complete recurrence information and form the basis on this report.Results: Total of 825 patients (43.6%) developed recurrence.According to location, 218 were distant (48.6%) with the remaining divided into: 113 pelvic (25.2%), 65 retroperitoneal (14.5%) and 53 to multiple sites (11.8%) such as pelvic and retroperitoneal or pelvic and distant.Most common distant sites were lungs (42%), bone (35.5%) and liver (27%).Median time to recurrence for entire population was 10.1 months (range 0 to 192.4) with 90% and 97% of all recurrences happening by 2 and 5 years post-cystectomy, respectively.When stratified according to stage, tumours with positive nodes (pTxN+) were more likely to recur than extravesical node-negative tumours (>pT3N0) and organ-confined node-negative tumours (≤pT2N0) (57% vs. 40.1% vs. 21.5% respectively, p < 0.0001).Similarly, pTxN+ tumours had a shorter median time to recurrence (9.1 months, range 0 to 71.6 months) compared to >pT3N0 tumours (9.5 months, range 0 to 69.5 months) and ≤pT2N0 tumours (13.7 months, range 0 to 192.4 months, p < 0.0001).Conclusions: Differences in recurrence patterns between the different subgroups after radical cystectomy suggest the need for varying followup protocols for patients in each.Chest radiographies are recommended once yearly for ≤pT2N0 tumours; every 6 months for the first 2 years then annually thereafter for >pT3N0 tumours; and every 3 months for the first year, then every 6 months thereafter for pTxN+ tumours.Triphasic CT scans of abdomen and pelvis are recommended on a yearly basis for ≤pT2N0 tumours; every 6 months for the first 2 years then annually thereafter for >pT3N0 tumours; and at 3 and 6 months postoperatively then every 6 months thereafter for 2 years then annually for pTxN+ tumours.
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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 | 0.003 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.004 | 0.001 |
| Open science | 0.001 | 0.003 |
| Research integrity | 0.002 | 0.003 |
| Insufficient payload (model declined to judge) | 0.728 | 0.576 |
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".