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

h 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.


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

Page: 1 2

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