- In patients with muscle-invasive bladder cancer (MIBC), delay in radical cystectomy (RC) of >12 weeks after transurethral resection of bladder tumor (TURBT) or 11 weeks after neoadjuvant chemotherapy (NACT) is associated with poorer OS.
- Rural neighborhood and change in TURBT and RC provider were associated with RC delays without NACT.
Why this matters
- Findings highlight health disparities on timely access to complex surgical care and care coordination.
- Study of 1509 patients with MIBC who underwent RC.
- Funding: University of Washington School of Medicine III Relocation Stipend and Howard J. Cohen Bladder Cancer Foundation.
- 18% of patients received NACT.
- Mean time from TURBT to NACT, 69 days.
- RC delays did not worsen survival in patients aged >80 years (P=.67).
- RC delay of >12 weeks after TURBT or >11 weeks after NACT was associated with increased risk for overall mortality vs timely surgery:
- no NACT (age
- after NACT (all patients): HR, 1.63 (95% CI, 1.06-2.52).
- Factors associated with RC delays in patients without NACT were high poverty or nonmetropolitan neighborhood, change in TURBT and RC provider, male sex.
- In patients who received NACT, a lymph node-positive status was associated with increased mortality.
- Retrospective design.