Quality of care in patients with bladder cancer: A case report?

Published on Mar 1, 2012in Cancer5.742
· DOI :10.1002/CNCR.26402
Karim Chamie27
Estimated H-index: 27
(UCLA: University of California, Los Angeles),
Christopher S. Saigal48
Estimated H-index: 48
(UCLA: University of California, Los Angeles)
+ 4 AuthorsMark S. Litwin93
Estimated H-index: 93
BACKGROUND: Although there is level I evidence demonstrating the superiority of intravesical therapy in patients with bladder cancer, surveillance strategies are primarily founded on expert opinion. The authors examined compliance with surveillance and treatment strategies and the pursuant impact on survival in patients with high-grade disease. METHODS: Using linked Surveillance, Epidemiology, and End Results (SEER)-Medicare data, the authors identified subjects with a diagnosis of high-grade, non–muscle-invasive disease between 1992 and 2002 who survived 2 years and did not undergo definitive treatment during that time. Nonlinear mixed-effects regression analyses was used to examine compliance with surveillance and treatment strategies. After adjusting for confounders using a propensity score-weighted approach, the authors determined whether individual and comprehensive strategies during the initial 2 years after diagnosis were associated with survival after 2 years. RESULTS: Of 4790 subjects, only 1 received all the recommended measures. Although mean utilization for most measures significantly increased after 1997, only compliance with an induction course of bacillus Calmette-Guerin (BCG) increased (13% to 20%; P < .001). On multivariate analysis, compliance with ≥ 4 cystoscopies, ≥ 4 cytologies, and BCG instillation was found to be lower among octogenarians and higher among those with undifferentiated, Tis, and T1 tumors, and among those individuals diagnosed after 1997. Subjects compliant with these measures had a lower hazard of mortality (hazard ratio, 0.41; 95% confidence interval, 0.18-0.93) than those who received < 4 cystoscopies, < 4 cytologies, and no BCG. CONCLUSION: There was a statistically significant survival advantage found among those who received at least half of the recommended care. Improving compliance with these process-of-care measures via systematic quality improvement initiatives serves as the primary target to meliorate bladder cancer care. Cancer 2012;. © 2011 American Cancer Society.
📖 Papers frequently viewed together
7 Authors (Karim Chamie, ..., Mark S. Litwin)
121 Citations
1,928 Citations
9 Authors (Ralph Madeb, ..., Edward M. Messing)
64 Citations
#1Ahmedin Jemal (ACS: American Cancer Society)H-Index: 139
#2Rebecca L. Siegel (ACS: American Cancer Society)H-Index: 67
Last. Elizabeth Ward (ACS: American Cancer Society)H-Index: 86
view all 4 authors...
Each year, the American Cancer Society estimates the number of new cancer cases and deaths expected in the United States in the current year and compiles the most recent data regarding cancer incidence, mortality, and survival based on incidence data from the National Cancer Institute, the Centers for Disease Control and Prevention, and the North American Association of Central Cancer Registries and mortality data from the National Center for Health Statistics. Incidence and death rates are age-...
11.4k CitationsSource
#1John M. Hollingsworth (UM: University of Michigan)H-Index: 27
#2Yun Zhang (UM: University of Michigan)H-Index: 15
Last. Brent K. Hollenbeck (UM: University of Michigan)H-Index: 63
view all 5 authors...
BACKGROUND: Given the uncertainty surrounding the optimal management for early stage bladder cancer, physicians vary in how they approach the disease. The authors of this report linked cancer registry data with medical claims to identify the sources of variation and opportunities for improving the value of cancer care. METHODS: By using data from the Surveillance, Epidemiology, and End Results-Medicare database (1992-2005), patients with early stage bladder cancer were abstracted (n = 18,276). T...
38 CitationsSource
#1Seth A. Strope (UM: University of Michigan)H-Index: 22
#2Zaojun Ye (UM: University of Michigan)H-Index: 24
Last. Brent K. Hollenbeck (UM: University of Michigan)H-Index: 63
view all 4 authors...
BACKGROUND: Early stage bladder cancer is a heterogeneous disease with a variable risk of progression and mortality. Uncertainty surrounding the optimal care for these patients may result in a mismatch between disease risk and treatment intensity. METHODS: Using Surveillance, Epidemiology, End Results-Medicare data, we identified patients diagnosed with early stage bladder cancer (n = 24,980) between 1993 and 2002. We measured patients' treatment intensity by totaling all Medicare payments made ...
24 CitationsSource
#1Ralph Madeb (UR: University of Rochester)H-Index: 20
#2Dragan Golijanin (UR: University of Rochester)H-Index: 35
Last. Edward M. Messing (UR: University of Rochester)H-Index: 83
view all 9 authors...
Background Phase III clinical trials performed primarily outside the United States (U.S.) demonstrate that intravesical instillation of chemotherapy immediately following transurethral resection of a bladder tumor (TURB) decreases recurrence rates. We sought to determine whether U.S. urologists have adopted this practice, and its potential effect on costs of bladder cancer (BC) care.
64 CitationsSource
#1Brent K. Hollenbeck (UM: University of Michigan)H-Index: 63
#2Zaojun Ye (UM: University of Michigan)H-Index: 24
Last. John D. Birkmeyer (UM: University of Michigan)H-Index: 106
view all 5 authors...
Background Bladder cancer is among the most prevalent and expensive to treat cancers in the United States. In the absence of high-level evidence to guide the optimal management of bladder cancer, urologists may vary widely in how aggressively they treat early-stage disease. We examined associations between initial treatment intensity and subsequent outcomes. Methods We used the Surveillance, Epidemiology, and End Results-Medicare database to identify patients who were diagnosed with early-stage ...
73 CitationsSource
#1George J. Huang (SC: University of Southern California)H-Index: 8
#2Ann S. Hamilton (SC: University of Southern California)H-Index: 67
Last. David F. Penson (SC: University of Southern California)H-Index: 80
view all 5 authors...
Purpose: In response to variations in cancer care organizations have developed clinical guidelines. In the case of nonmuscle invasive bladder cancer, also known as superficial bladder cancer, 2 similar sets of guidelines were released in the late 1990s that provide care recommendations. We examined patterns of intravesical therapy use in nonmuscle invasive bladder cancer in 2003 to determine whether disparities remained in the quality of cancer care.Materials and Methods: Data from the SEER (Sur...
36 CitationsSource
#1Erica H. Lambert (CUMC: Columbia University Medical Center)H-Index: 7
#2Phillip M. Pierorazio (CUMC: Columbia University Medical Center)H-Index: 42
Last. Steven Poon (CUMC: Columbia University Medical Center)H-Index: 1
view all 6 authors...
OBJECTIVE Intravesical therapy (IVT), chemo and immunotherapy, has made conservative, bladder-sparing strategies a viable option for managing patients with high grade T1 bladder cancer. However, many of these patients will have recurrence and occasionally progression, questioning delayed intervention. This study examines the patterns of use of IVT in high-grade T1 bladder cancer and the subsequent impact on survival for patients ultimately proceeding to radical cystectomy (RC). PATIENTS AND METH...
83 CitationsSource
#1Cheryl T. Lee (UM: University of Michigan)H-Index: 42
#2Rodney L. Dunn (UM: University of Michigan)H-Index: 74
Last. David P. Wood (UM: University of Michigan)H-Index: 76
view all 5 authors...
Objectives Surveillance of early-stage bladder cancer (cTis-T1) permits bladder preservation with conservative treatments, using cystectomy to salvage patients with refractory disease. Despite close observation, some tumors progress to muscle invasion during this period. Historically, some believed that cystectomy applied in this setting could provide a better outcome in patients with “early” cT2 disease compared with those with de novo cT2 disease. We compared the pathologic and survival outcom...
38 CitationsSource
#1Meredith B. Rosenthal (Harvard University)H-Index: 53
#2Bruce E. LandonH-Index: 82
Last. Arnold M. EpsteinH-Index: 105
view all 5 authors...
Background Pay for performance has increasingly become the subject of intense interest and debate, both of which have been heightened as the Centers for Medicare and Medicaid Services moves closer to adopting this approach for Medicare. Although many claims have been made for the effectiveness of this approach, the extent of its national penetration remains unknown. Methods We surveyed a sample of 252 health maintenance organizations (HMOs) (response rate, 96%) drawn from 41 metropolitan areas a...
340 CitationsSource
#1Deborah Schrag (MSK: Memorial Sloan Kettering Cancer Center)H-Index: 104
#2Nandita Mitra (MSK: Memorial Sloan Kettering Cancer Center)H-Index: 60
Last. Colin B. Begg (MSK: Memorial Sloan Kettering Cancer Center)H-Index: 91
view all 7 authors...
Abstract Objectives To describe the population-based patterns of care among patients with muscle-invasive bladder cancer. Methods A retrospective cohort study using the Surveillance, Epidemiology and End Results (SEER)-Medicare database identified 4664 patients aged 65 years or older with muscle-invasive bladder cancer diagnosed between 1991 and 1999. The use of particular treatment modalities was evaluated according to the clinical and demographic characteristics available in the SEER-Medicare ...
80 CitationsSource
Cited By52
#1Emina Kayama (Keio: Keio University)H-Index: 1
#2Keisuke Shigeta (Keio: Keio University)H-Index: 5
Last. Mototsugu Oya (Keio: Keio University)H-Index: 56
view all 12 authors...
Background The relationship between guideline adherence for radical cystectomy of non-muscle-invasive bladder cancer and patient prognoses currently remains unclear. We investigated whether guideline adherence at the time of non-muscle-invasive bladder cancer affects the oncological outcomes of bladder cancer patients who underwent radical cystectomy. Methods Among 267 cTa-4N0-2M0 bladder cancer patients, 70 who underwent radical cystectomy under the non-muscle-invasive bladder cancer or muscle-...
#1Grant M Henning (WashU: Washington University in St. Louis)H-Index: 1
#2Nimrod S. Barashi (WashU: Washington University in St. Louis)H-Index: 5
Last. Zachary L. Smith (WashU: Washington University in St. Louis)H-Index: 11
view all 3 authors...
Abstract Bladder cancer may present management challenges as it frequently recurs and can progress when not expeditiously diagnosed and carefully monitored following initial therapy for non-invasive disease. Cystoscopy and cytology have long been the primary tools for the urologist treating bladder cancer. However, as a host of potential biomarkers have been developed, new avenues for non-invasive testing have become available in the detection, surveillance, and prognostic setting. Analysis of u...
Background Long non-coding RNAs (lncRNAs) are essential regulators for various human cancers. However, these lncRNAs need to be further classified for cancer. In the present study, we identified novel competing endogenous RNA (ceRNA) network for bladder cancer (BC) and explored the gene functions of the ceRNA regulatory network. Methods Differential gene expression analysis were performed on The Cancer Genome Atlas Urothelial Bladder Carcinoma (TCGA-BLCA) datasets to identify differentially expr...
1 CitationsSource
#1Michael E. Rezaee (Veterans Health Administration)H-Index: 6
#2A. Aziz Ould Ismail (Veterans Health Administration)
Last. Florian R. SchroeckH-Index: 20
view all 6 authors...
Abstract Background It is important to understand the implications of reduced bacillus Calmette-Guerin (BCG) treatment intensity, given global shortages and early termination of the NIMBUS trial. Objective To assess the association of partial versus complete BCG induction with outcomes. Design, setting, and participants This is a retrospective cohort study of veterans diagnosed with high-risk non–muscle-invasive bladder cancer (NMIBC; high grade [HG] Ta, T1, or carcinoma in situ) between 2005 an...
1 CitationsSource
#1Tullika GargH-Index: 12
#2Carmit K. McMullen (KP: Kaiser Permanente)H-Index: 27
Last. Matthew E. NielsenH-Index: 54
view all 6 authors...
BACKGROUND Nonmuscle-invasive bladder cancer (NMIBC) has heterogeneous recurrence and progression outcomes. Available risk calculators estimate recurrence and progression but do not predict the recurrence stage or grade, which may influence downstream treatment. The objective of this study was to predict risk-stratified NMIBC recurrence and progression based on recurrence tumor classification and grade. METHODS In total, 2956 patients with NMIBC (
#1Soraia Teles (University of Porto)H-Index: 5
#2Ana Ferreira (University of Porto)H-Index: 15
Last. Constança Paúl (University of Porto)H-Index: 23
view all 3 authors...
Participant attitudes are an explanatory factor for attrition in online health-related interventions. However, its assessment prior to interventions start is uncommon, partly because proper measures are missing. This study presents the psychometric properties of a new scale measuring attitudes towards online psychoeducational interventions (OPIs). Structural validity, reliability and screening performance of the Online Psychoeducational Intervention - Brief Attitudes Scale (OPI-BAS) were studied...
1 CitationsSource
Oct 26, 2020 in CHI (Human Factors in Computing Systems)
#1Márcia Coelho Cardoso (PUCRS: Pontifícia Universidade Católica do Rio Grande do Sul)
#2Milene Selbach Silveira (PUCRS: Pontifícia Universidade Católica do Rio Grande do Sul)H-Index: 12
Due to the constant need for improvement in the quality of education, there has been a growing interest in technological tools to support design for teaching and learning in a student-centered way. As a result, the development of these tools has increased. However, it is not clear what shapes teachers' design decisions and how tools can best support their design processes. Also, researches on Virtual Learning Environments (VLEs) have shown that teachers usually do not explore VLEs to their full ...
#1Kyle A. Richards (UW: University of Wisconsin-Madison)H-Index: 11
#2Shih-Wen Lin (Genentech)H-Index: 2
Last. Gary D. Steinberg (NYU: New York University)H-Index: 5
view all 10 authors...
Abstract Objective To characterize Bacillus Calmette-Guerin (BCG) treatment patterns and associated outcomes in a large cohort of patients with non–muscle-invasive bladder cancer (NMIBC). Methods Our retrospective analysis of patients aged ≥ 66 years with stage 0-1 urothelial bladder carcinoma diagnosed between 2000 and 2012 in the US Surveillance, Epidemiology, and End Results (SEER)–Medicare database estimated proxies for recurrence and secondary events and both all-cause and bladder cancer–sp...
1 CitationsSource
#1Keiichiro Mori (Jikei University School of Medicine)H-Index: 8
#2Noriyoshi Miura (Ehime University)H-Index: 4
Last. Shahrokh F. ShariatH-Index: 132
view all 12 authors...
Abstract Purpose: This systematic review assessed compliance to guidelines for the management of nonmuscle-invasive bladder carcinoma (NMIBC). Methods: The PUBMED, Web of Science, Cochrane Library, and Scopus databases were searched in November 2019 in accordance with the Preferred Reporting Items for Systematic Review and Meta-analysis statement. Results: Fifteen studies incorporating a collective total of 10,575 NMIBC patients were eligible for inclusion in this systematic review. We found tha...
6 CitationsSource
#1Clint Cary (Veterans Health Administration)H-Index: 2
#2Laura G. MilitelloH-Index: 19
Last. Michael W. Weiner (Veterans Health Administration)H-Index: 104
view all 6 authors...
AbstractIntroduction:The intravesical instillation of mitomycin C immediately following surgery for nonmuscle invasive bladder cancer has been shown to be efficacious in reducing cancer recurrence....