UICC World Cancer Congress 2006

Objective: Standard treatment for invasive urinary bladder tumors (IUBT) without extension to perivesical fat includes trans-urethral excision of the tumor or cystectomy, with or without pelvic lymph node dissection. If surgery is not recommended, patients should receive external-beam irradiation with or without interstitial seed implantation. This investigation aims to determine the extent to which patients from the New York City (NYC) metropolitan area receive recommended therapeutic/staging procedures recommended for IUBT. In addition, we analyze the association between treatment and certain socio-demographic characteristics of the patients.

Methods: To avoid issues related to geographical barriers to care, the research focused on IUBT patients diagnosed in NYC and counties adjacent to NYC. Localized IUBT cases diagnosed between 2001-2002 were selected from the New York State Cancer Registry. The registry provided data on the first course of treatment (surgical procedure type, lymph node surgery, radiation treatment) and sociodemographic characteristics (age, sex, race, Hispanic origin, birthplace).

Results: Treatment data were available for over 99% of cases. The proportion of patients with standard surgical treatment was 94.4%. Of those with standard surgical treatment, 7.2% received radical cystectomy. Pelvic lymph node dissection was done for either staging or treatment in less than 7% of cases. External beam irradiation following surgery was reported for approximately 3% of surgical cases. Age (over 75 years), sex (female) and race (non-white) were associated with less frequent standard surgical treatment and more frequent radiation therapy. Radical cystectomy and pelvic lymph node dissection was less frequent in older people and in whites.