Navigation Links
More intensive treatment not associated with better outcomes in early bladder cancer
Date:4/7/2009

Patients with early bladder cancer who receive more intensive treatment within the first two years of diagnosis do not appear to have better survival than patients who receive less intensive treatment, according to a retrospective analysis published in the April 7 online issue of the Journal of the National Cancer Institute.

Although bladder cancer is the fifth most common cancer in the United States, optimal treatment strategies for the disease remain unclear and there are relatively few data available from randomized controlled clinical trials. Current treatment guidelines favor more intense surveillance and therapy, but individual urologists vary in their approach to treatment.

In the current study, Brent K. Hollenbeck, M.D., of the University of Michigan Health System in Ann Arbor, and colleagues used the Surveillance, Epidemiology, and End Results database and linked patient information in the Medicare database to determine whether more intensive early treatment was associated with better outcomes. The investigators identified 20,713 patients diagnosed with early bladder cancer between 1992 and 2002. They estimated the intensity of treatment based on Medicare costs in the first two years following diagnosis and then divided the 940 treating physicians into four groups based on their average cost of treatment.

The average cost of care for early bladder cancer was $2,830 in the least treatment-intense group compared with an average cost of $7,131 in the most treatment-intense groups. More intensive treatment was not associated with better overall survival. Patients who underwent more intensive early treatment were more likely to undergo major interventions later.

"The hightreatment intensity style of practice was characterized by a greater use of all measured health services, including intravesical therapy, endoscopy, urinary studies, and imaging," the authors write. "However, this aggressive early treatment approach did not improve survival or prevent patients from having to undergo major medical interventions in subsequent years. In fact, compared with patients treated by lowtreatment intensity urologists, those treated by hightreatment intensity urologists were nearly two and one-half times more likely to undergo radical cystectomy and nearly twice as likely to receive any major medical intervention, even after accounting for patient differences."

In an accompanying editorial, Gary H. Lyman, M.D., and colleagues of Duke University School of Medicine in Durham, point out that retrospective studies based on healthcare claims need to be interpreted with caution. Important clinical information, which affects treatment decisions, may not be included in such databases. Additionally it is impossible to adjust for unmeasured factors which might influence the results. "The apparent association between provider treatment intensity defined as greater average bladder cancer expenditures and worse bladder cancerspecific but not overall survival is more likely the result of confounding by unavailable prognostic factors than the result of adverse events resulting from the procedures themselves," the editorialists write.


'/>"/>

Contact: Caroline McNeil
jncimedia@oxfordjournals.org
301-841-1287
Journal of the National Cancer Institute
Source:Eurekalert

Related medicine news :

1. Large intensive care study reveals vital recommendations for treatment of brain injury patients
2. Browns Wives Host Special Day at MetroHealth Medical Center to Support the Neonatal Intensive Care Unit
3. Smoking Cessation Rates Double With Intensive Counseling and Free Nicotine Replacement Therapy, Studies of 20,000 Smokers Show
4. Intensive care quality of sleep improved by new drug, reports study
5. Intensive training post-spinal cord injury can stimulate repair in brain and spinal cord
6. Susan G. Komen for the Cure Sharing Grassroots Advocacy Knowledge With International Representatives in Intensive Dallas Training Session
7. Intensive blood sugar treatment in trial of diabetes and cardiovascular disease changed
8. Construction Commencing at Gilbert Hospitals New Intensive Care Unit
9. Intensive care units prevention of pneumonia in critically-ill patients generally strong
10. Mayo Clinic Research Shows U.S. Intensive Care Units Prevention of Pneumonia in Critically-ill Patients Generally Strong; Identifies Area of Improvement
11. More intensive dialysis does not improve outcomes among patients with acute kidney injury
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:6/25/2016)... ... 25, 2016 , ... Experts from the American Institutes for ... Meeting June 26-28, 2016, at the Hynes Convention Center in Boston. , AIR ... care planning, healthcare costs and patient and family engagement. , AIR researchers will ...
(Date:6/25/2016)... ... June 25, 2016 , ... As a lifelong Southern Californian, Dr. ... his M.D from the David Geffen School of Medicine at UCLA. He trained in ... to complete his fellowship in hematology/oncology at the UCLA-Olive View-Cedars Sinai program where he ...
(Date:6/24/2016)... ... June 24, 2016 , ... Those who have experienced ... feelings, many turn to unhealthy avenues, such as drug or alcohol abuse, as a ... has released tools for healthy coping following a traumatic event. , Trauma sufferers tend ...
(Date:6/24/2016)... ... June 24, 2016 , ... Dr. Amanda Cheng, an ... Dr. Cheng has extensive experience with all areas of orthodontics, including robotic Suresmile ... orthodontics. , Micro-osteoperforation is a revolutionary adjunct to orthodontic treatment. It can ...
(Date:6/24/2016)... ... 24, 2016 , ... The Haute Beauty Network, affiliated with ... as a prominent plastic surgeon and the network’s newest partner. , Dr. ... handsome men, look naturally attractive. Plastic surgery should be invisible.” He stands by ...
Breaking Medicine News(10 mins):
(Date:6/26/2016)... , June 27, 2016  VMS Rehab Systems, ... Board will take whatever measures required to build a ... stock which is currently listed on the OTC Markets-pink ... Company Chairman and CEO, "We are seeing an anomaly ... to understand, not only by the Company, but shareholders ...
(Date:6/24/2016)... , June 24, 2016  Global Blood ... biopharmaceutical company developing novel therapeutics for the treatment ... today announced the closing of its previously announced ... stock, at the public offering price of $18.75 ... offering were offered by GBT. GBT estimates net ...
(Date:6/24/2016)... June 24, 2016 The Academy of Managed ... recommendations that would allow biopharmaceutical companies to more ... that make formulary and coverage decisions, a move that ... new medicines. The recommendations address restrictions in ... on the drug label, a prohibition that hinders decision ...
Breaking Medicine Technology: