PURPOSE: In Canada there is growing concern that waiting time for cancer surgery has been increasing. We used population based data to estimate the average PD for RC in Quebec and assess whether delayed surgery has a negative impact on long-term survival. MATERIALS AND METHODS: We used the provincial billing database of the maladie du Quebec to identify all patients with bladder cancer 18 years or older who underwent RAMQ from 1990 to 2002. PD was calculated as the time elapsed between the most recent transurethral resection and the date of RC. Patients were categorized according to PD tertiles into 3 groups, namely 1) 20 or less, 2) 21 to 47 and (C) 48 days or greater. Cox proportional hazards models were used to assess the effect of PD on overall survival, while adjusting for patient and provider factors. RESULTS: During the study period 1,592 radical cystectomies were performed. Overall median PD was 33 days (95% CI 30 to 35). Median PD increased from 23 days in 1990 to 50 in 2002. After adjusting for calendar year, and patient and provider variables there were no significant differences in survival among the 3 delay categories. However, patients subject to greater than 12 weeks of delay were at 20% greater risk for dying (95% CI 1.0 to 1.5, p = 0.051). CONCLUSIONS: In line with previous reports PD greater than 12 weeks seems to be associated with a worse long-term prognosis.
PURPOSE: In Canada there is growing concern that waiting time for cancer surgery has been increasing. We used population based data to estimate the average PD for RC in Quebec and assess whether delayed surgery has a negative impact on long-term survival. MATERIALS AND METHODS: We used the provincial billing database of the maladie du Quebec to identify all patients with bladder cancer 18 years or older who underwent RAMQ from 1990 to 2002. PD was calculated as the time elapsed between the most recent transurethral resection and the date of RC. Patients were categorized according to PD tertiles into 3 groups, namely 1) 20 or less, 2) 21 to 47 and (C) 48 days or greater. Cox proportional hazards models were used to assess the effect of PD on overall survival, while adjusting for patient and provider factors. RESULTS: During the study period 1,592 radical cystectomies were performed. Overall median PD was 33 days (95% CI 30 to 35). Median PD increased from 23 days in 1990 to 50 in 2002. After adjusting for calendar year, and patient and provider variables there were no significant differences in survival among the 3 delay categories. However, patients subject to greater than 12 weeks of delay were at 20% greater risk for dying (95% CI 1.0 to 1.5, p = 0.051). CONCLUSIONS: In line with previous reports PD greater than 12 weeks seems to be associated with a worse long-term prognosis.
Authors: Wassim Kassouf; Armen Aprikian; Fred Saad; Rodney H Breau; Girish Kulkarni; David M Guttman; Ken Bagshaw; Jonathan Izawa; Libni Eapen; Adrian Fairey; Alan So; Scott North; Ricardo Rendon; Srikala S Sridhar; Fadi Brimo; Peter Chung; Darrel Drachenberg; Yves Fradet; Niels Jacobsen; Chris Morash; Bobby Shayegan; Geoffrey Gotto; Alex Zlotta; Neil Fleshner; D Robert Siemens; Peter C Black Journal: Can Urol Assoc J Date: 2018-03-19 Impact factor: 1.862
Authors: Vignesh Raman; Oliver K Jawitz; Soraya L Voigt; Chi-Fu J Yang; Hanghang Wang; David H Harpole; Thomas A D'Amico Journal: J Thorac Cardiovasc Surg Date: 2019-10-08 Impact factor: 5.209
Authors: Atreya Dash; Joseph A Pettus; Harry W Herr; Bernard H Bochner; Guido Dalbagni; S Machele Donat; Paul Russo; Mary G Boyle; Matthew I Milowsky; Dean F Bajorin Journal: Cancer Date: 2008-11-01 Impact factor: 6.860
Authors: Wassim Kassouf; Armen Aprikian; Peter Black; Girish Kulkarni; Jonathan Izawa; Libni Eapen; Adrian Fairey; Alan So; Scott North; Ricardo Rendon; Srikala S Sridhar; Tarik Alam; Fadi Brimo; Normand Blais; Chris Booth; Joseph Chin; Peter Chung; Darrel Drachenberg; Yves Fradet; Michael Jewett; Ron Moore; Chris Morash; Bobby Shayegan; Geoffrey Gotto; Neil Fleshner; Fred Saad; D Robert Siemens Journal: Can Urol Assoc J Date: 2016-02-08 Impact factor: 1.862