Prompt bladder cancer surgery aids disease control

A delay of more than about 3 months before performing radical cystectomy for muscle invasive bladder cancer can result in greater pathology, researchers report in the October issue of the Journal of Urology.

‘Although careful preoperative evaluation and preparation is important,’ lead investigator Dr. Sam S. Chang told Reuters Health that ‘undue delay…makes it more likely that a more advanced stage tumor is found–one which may not be as likely to be cured by surgery.’Dr. Chang and colleagues at Vanderbilt University Medical Center, Nashville, Tennessee, came to this conclusion after studying data on 303 patients who underwent radical cystectomy during a 4-year period.The time from transurethral resection diagnosis of muscle invasive disease until cystectomy ranged from 8 to 473 days, with a mean of 63 days. In total, 81% of patients in whom this interval was 90 days or more had stage pT3 or higher non-organ-confined disease versus 52% of those who had the procedure sooner.In addition, patients with organ-confined disease had a significantly shorter time between diagnosis and cystectomy (47.5 days) than those who did not have organ-confined disease (75.1 days).Although, ’90 days may be somewhat arbitrary length of time from diagnosis until surgery,’ Dr. Chang concluded, ‘patients who had radical cystectomy performed during this time period were more likely to have organ-confined disease.'(Source: J Urol 2003;170:1085-1087: Reuters Health: David Douglas: October 30, 2003: Oncolink)