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 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 | 0.001 |
| Insufficient payload (model declined to judge) | 0.013 | 0.001 |
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".