Hou Xiaojie, Li Nan, Ruan Lin, Yao Xiaoguang, Feng Xiaole, Hou Xuekun, Chu Zefei, Cui Shuanlong, Li Qiang
College of Acupuncture and Massage, Hebei University of Chinese Medicine, Shijiazhuang, China.
Department of Nephrology, The First Hospital of Hebei Medical University, Shijiazhuang, China.
Transl Androl Urol. 2024 Sep 30;13(9):2079-2091. doi: 10.21037/tau-24-148. Epub 2024 Sep 26.
Cancer treatment delay is a global health system issue. However, data concerning the impact of treatment delays on survival in bladder cancer remain controversial. This study sought to evaluate the impact of time from diagnosis to treatment on survival outcomes of bladder cancer patients in the US Surveillance, Epidemiology, and End Results (SEER) database.
The SEER was searched from 2000 to 2020 for bladder cancer patients. Logistical regression was used to explore potential factors related to treatment delay. Kaplan-Meier curves were generated to investigate the overall and cancer-specific survival. Multivariate Cox proportional hazards regression models were used to evaluate the effects of covariables on survival outcomes in bladder cancer with treatment delay.
There were 12,686 eligible patients included in this study. A total of 2,379 patients experienced an initial treatment delay. Initial treatment delay was related to worse survival. Sex, age, pathological grade, clinical stage, and surgery were associated with increased odds of initial treatment delay. In the patients with initial treatment delay, age, advanced stage, lymph node involvement, high pathological grades and metastasis were independent predictors of poor overall survival and cancer-specific survival, while marital status at diagnosis, surgery, chemotherapy, and radiotherapy were found to improve both overall survival and cancer-specific survival.
Significant disparities in pathological/clinical variables could contribute to treatment delay. Surgery, chemotherapy, and radiotherapy benefited the survival of patients with treatment delays.
癌症治疗延迟是一个全球性的卫生系统问题。然而，关于治疗延迟对膀胱癌生存影响的数据仍存在争议。本研究旨在评估美国监测、流行病学和最终结果（SEER）数据库中从诊断到治疗的时间对膀胱癌患者生存结局的影响。
在SEER数据库中检索2000年至2020年的膀胱癌患者。采用逻辑回归分析探索与治疗延迟相关的潜在因素。绘制Kaplan-Meier曲线以研究总生存率和癌症特异性生存率。使用多变量Cox比例风险回归模型评估协变量对存在治疗延迟的膀胱癌患者生存结局的影响。
本研究共纳入12686例符合条件的患者。共有2379例患者经历了初始治疗延迟。初始治疗延迟与较差的生存率相关。性别、年龄、病理分级、临床分期和手术与初始治疗延迟几率增加有关。在初始治疗延迟的患者中，年龄、晚期、淋巴结受累、高病理分级和转移是总生存率和癌症特异性生存率差的独立预测因素，而诊断时的婚姻状况、手术、化疗和放疗可改善总生存率和癌症特异性生存率。
病理/临床变量的显著差异可能导致治疗延迟。手术、化疗和放疗对存在治疗延迟的患者的生存有益。
