Thorsteinsson Kira, Brandt Simone Buchardt, Jensen Jørgen Bjerggaard
Department of Urology, Aarhus University Hospital, 8200 Aarhus, Denmark.
Department of Clinical Medicine, Aarhus University, 8200 Aarhus, Denmark.
Cancers (Basel). 2025 Mar 25;17(7):1105. doi: 10.3390/cancers17071105.
A subset of patients with locally advanced or metastatic bladder cancer (la/mBC) do not receive systemic oncological treatment. The reasons for refraining from systemic treatment are poorly investigated, as are the characteristics of patients who turn out to be long-term survivors despite lack of treatment.
This retrospective observational cohort study included patients with registration compatible with la/mBC who did not undergo systemic treatment. They were seen at a single tertiary university hospital covering one of 5 Danish regions in the study period from 1 January 2012 until 31 December 2022. Patients were identified through a coding system, and detailed patient information was obtained in the electronic medical records.
The initial study population consisted of 472 patients registered with la/mBC according to codes in the patient registries but with no registration of systemic oncological treatment. Out of the total cohort, 159 patients were registered correctly, while the rest of the population were excluded due to misclassification, as 10.8% did not have la/mBC and 55.5% had received oncological treatment. Among correctly registered patients, the median overall survival was 2.6 months (95% CI 0.26; 4.94) from being diagnosed with la/mBC. The most common reasons for lack of treatment were poor general condition (74.2%), patient preference (19.5%), and poor renal function (11.9%).
Our study found that a significant amount of patients in a cohort of suspected la/mBC not undergoing treatment either received oncological treatment or did not have la/mBC, demonstrating a misclassification in the system. This should be taken into consideration when evaluating data about survival time for this patient group. The poorest survival of untreated la/mBC is associated with a high tumor burden and specifically liver metastasis.
一部分局部晚期或转移性膀胱癌（la/mBC）患者未接受全身肿瘤治疗。对于不进行全身治疗的原因以及尽管未接受治疗却成为长期幸存者的患者特征，研究较少。
这项回顾性观察队列研究纳入了符合la/mBC登记标准但未接受全身治疗的患者。在2012年1月1日至2022年12月31日的研究期间，他们在一家覆盖丹麦5个地区之一的三级大学医院接受诊治。通过编码系统识别患者，并从电子病历中获取详细的患者信息。
初始研究人群包括472例根据患者登记编码符合la/mBC但无全身肿瘤治疗登记的患者。在整个队列中，159例患者登记正确，其余患者因分类错误被排除，因为10.8%的患者没有la/mBC，55.5%的患者接受过肿瘤治疗。在登记正确的患者中，从被诊断为la/mBC起，中位总生存期为2.6个月（95%CI 0.26；4.94）。未接受治疗的最常见原因是一般状况差（74.2%）、患者偏好（19.5%）和肾功能差（11.9%）。
我们的研究发现，在疑似la/mBC且未接受治疗的队列中，相当一部分患者要么接受过肿瘤治疗，要么没有la/mBC，这表明系统存在分类错误。在评估该患者群体的生存时间数据时应考虑到这一点。未经治疗的la/mBC患者最差的生存情况与高肿瘤负荷特别是肝转移有关。
