Department of Oncology, Copenhagen University Hospital, Rigshospitalet, Denmark.
Department of Urology, Copenhagen University Hospital, Rigshospitalet, Denmark.
Acta Oncol. 2022 Sep;61(9):1036-1042. doi: 10.1080/0284186X.2022.2114378. Epub 2022 Aug 25.
The proportion of patients with locally advanced, unresectable or metastatic urothelial carcinoma that do not receive systemic anticancer treatment and the reasons for lack of treatment are largely unknown. The aim of this study was to investigate the prevalence and overall survival of this patient group and reasons for omission of treatment.
This retrospective, single-center cohort study from Rigshospitalet, Denmark included patients diagnosed with locally advanced, unresectable or metastatic urothelial carcinoma during the study period from 1 January 2010 to 31 March 2016 who did not receive systemic anticancer treatment. Patients were identified through the Danish Pathology Register and the electronic medical records.
100 patients were included, representing 34% of all patients diagnosed with locally advanced, unresectable or metastatic urothelial carcinoma at Rigshospitalet during the study period. Lack of treatment was most often due to poor physical condition (59%), decreased renal function (15%), or patient preferences (14%). Median overall survival was 1.9 months (95% CI: 1.6-2.8 months).
One in three patients diagnosed with locally advanced, unresectable or metastatic urothelial carcinoma in the pre-immunotherapy era did not receive systemic anticancer treatment. Prompt identification of advanced disease and interventions to optimize these patients for treatment are essential. Our findings underscore the compelling need for novel, better tolerated treatment regimens in this frail patient group.
在局部晚期、不可切除或转移性尿路上皮癌患者中，有很大一部分未接受系统抗癌治疗，且治疗缺失的原因尚不清楚。本研究旨在调查该患者群体的患病率和总生存率以及治疗遗漏的原因。
这是一项来自丹麦里瑟医院的回顾性单中心队列研究，纳入了在研究期间（2010 年 1 月 1 日至 2016 年 3 月 31 日）被诊断为局部晚期、不可切除或转移性尿路上皮癌但未接受系统抗癌治疗的患者。通过丹麦病理登记处和电子病历识别患者。
共纳入 100 例患者，占研究期间里瑟医院所有局部晚期、不可切除或转移性尿路上皮癌患者的 34%。治疗缺失最常归因于身体状况不佳（59%）、肾功能下降（15%）或患者偏好（14%）。中位总生存期为 1.9 个月（95%CI：1.6-2.8 个月）。
在免疫治疗前时代，每 3 名被诊断为局部晚期、不可切除或转移性尿路上皮癌的患者中，就有 1 名未接受系统抗癌治疗。及时发现晚期疾病并采取措施优化这些患者的治疗条件至关重要。我们的研究结果强调了在这一脆弱患者群体中需要新型、耐受性更好的治疗方案。
