INTRODUCTION: Time that passes between an unfavourable diagnosis to a radical cystectomy (RC) affects oncological outcomes in patients with bladder cancer. Unsatisfactory survival of patients after RC in Central Europe can potentially result from this factor. MATERIAL AND METHODS: The aim of this study was to assess the time interval between transurethral resection of the bladder tumor (TURBT) and RC in Central Europe and to identify clinical factors of possible delays. 941 consecutive patients who underwent RC in nine Central European urological centers were enrolled into the study. After the TURBT-RC time was calculated, selected clinical and pathological parameters were tested as potential factors influencing the timing of RC. RESULTS: On average, RCs were performed 73.8 days after TURBTs (median - 53, range 0-1587). In 238 patients (25.3%) the time exceeded 12 weeks. Patients with muscle-invasive cancer were operated earlier on than patients with nonmuscle-invasive cancer (67.6 vs.105.2 days, RR = 1.41, p = 0.00). In high volume centers (>30 RC per year) longer TURBT-RC intervals were observed (97.6 vs. 66.3 days, RR = 2.49, p = 0.00). Simultaneously, factors such as female sex (RR = 1.21), more advanced age of patient (>65 years, RR = 1.23), presence of concomitant CIS (RR = 2.43), grade of cancer cells (RR = 1.67) and final post-RC stage (RR = 1.51) had no statistically significant effect on the results (p >0.05). CONCLUSIONS: The mean time interval between the diagnosis and radical treatment of patients with bladder cancer in Central Europe is adequate. However, there are still a relatively high number of patients waiting for radical cystectomy longer than 8 weeks. A lower stage of disease as well as a higher case load within of a hospital may delay the surgery.

Burghele Clinical Hospital Department of Urology Bucharest Romania

Carol Davila Medical University Department of Urology Bucharest Romania

Ceynowa Hospital Department of Urology Wejherowo Poland

Charles University 2nd Faculty of Medicine Teaching Hospital in Motol Department of Urology Prague Czech Republic

Colentina Clinical Hospital Department of Urology Bucharest Romania

Lviv Regional Clinical Hospital Department of Urology Lviv Ukraine

Medical University of Warsaw Department of Urology Warsaw Poland

National Academy of Medical Sciences of Ukraine Institute of Urology Department of Restorative Urology and Newest Technology Kyiv Ukraine

Pomeranian Medical University Department of Urology and Urological Oncology Szczecin Poland

Zobrazit více v PubMed

Witjes JA, Compérat E, Cowan NC, De Santis M, Gakis G, Lebret T, et al. EAU guidelines on muscle–invasive and metastatic bladder cancer: summary of the 2013 guidelines. Eur Urol. 2014;65:778–792. PubMed

Babjuk M, Burger M, Zigeuner R, Shariat SF, van Rhijn BW, Compérat E, et al. EAU guidelines on non–muscle–invasive urothelial carcinoma of the bladder: update 2013. Eur Urol. 2013;64:639–653. PubMed

Booth CM, Siemens DR, Li G, Peng Y, Tanncok IF, Kong W, et al. Perioperative chemotherapy for muscle–invasive bladder cancer: A population–based outcomes study. Cancer. 2014;120:1630–1638. PubMed

Linder BJ, Frank I, Cheville JC, Tollefson MK, Thompson RH, et al. The impact of perioperative blood transfusion on cancer recurrence and survival following radical cystectomy. Eur Urol. 2013;63:839–845. PubMed

Sonpavde G, Khan MM, Lerner SP, Svatek RS, Novara G, Karakiewicz PI, et al. Disease–free survival at 2 or 3 years correlates with 5–year overall survival of patients undergoing radical cystectomy for muscle invasive bladder cancer. J Urol. 2011;185:456–461. PubMed

Ossoliński K, Gilarowska A, Peller M, Dybowski B, Radziszewski P, Borkowski A. Total survival after radical cystectomy in patient with urothelial bladder cancer. Cent European J Urol. 2012;(suppl 1):56.

Lemiński A, Puszyński M, Kupś M, Słojewski M, Sikorski A. Treatment of invasive bladder tumors in Polish conditions – single center observations of 402 patients after radical cystectomy. Cent European J Urol. 2012;(suppl 1):55.

Gore JL, Lai J, Setodji CM, Litwin MS, Saigal CS, Urologic Diseases in America Project Mortality increases when radical cystectomy is delayed more than 12 weeks: results from a Surveillance, Epidemiology, and End Results–Medicare analysis. Cancer. 2009;115:988–996. PubMed PMC

Lee CT, Madii R, Daignault S, Dunn RL, Zhang Y, Montie JE, Wood DP., Jr Cystectomy delay more than 3 months from initial bladder cancer diagnosis results in decreased disease specific and overall survival. J Urol. 2006;175:1262–1267. PubMed

May M, Nitzke T, Helke C, Vogler H, Hoschke B. Significance of the time period between diagnosis of muscle invasion and radical cystectomy with regard to the prognosis of transitional cell carcinoma of the urothelium in the bladder. Scand J Urol Nephrol. 2004;38:231–235. PubMed

Chang SS, Hassan JM, Cookson MS, Wells N, Smith JA., Jr Delaying radical cystectomy for muscle invasive bladder cancer results in worse pathological stage. J Urol. 2003;170:1085–1087. PubMed

Sánachez–Ortiz RF, Huang WC, Mick R, Van Arsdalen KN, Wein AJ, Malkowicz SB. An interval longer than 12 weeks between the diagnosis of muscle invasion and cystectomy is associated with worse outcome in bladder carcinoma. J Urol. 2003;169:110–115. PubMed

Hara I, Miyake H, Hara S, Gotoh A, Okada H, Arakawa S, Kamidono S. Optimal timing of radical cystectomy for patients with invasive transitional cell carcinoma of the bladder. Jpn J Clin Oncol. 2002;32:14–18. PubMed

Poletajew S, Lisiński J, Moskal K, Ornat J, Renk K, Szlaga M, et al. The time from diagnosis of bladder cancer to radical cystectomy in Polish urological centres – results of CysTiming Poland study. Cent European J Urol. 2014;67:329–332. PubMed PMC

Liedberg F, Anderson H, Mansson W. Treatment delay and prognosis in invasive bladder cancer. J Urol. 2005;174:1777–1781. PubMed

Schrier BP, Hollander MP, van Rhijn BW, Kiemeney LA, Witjes JA. Prognosis of muscle–invasive bladder cancer: difference between primary and progressive tumours and implications for therapy. Eur Urol. 2004;45:292–296. PubMed

Jäger W, Thomas C, Haag S, Hampel C, Salzer A, Thüroff JW, Wiesner C. Early vs delayed radical cystectomy for ‘high–risk’ carcinoma not invading bladder muscle: delay of cystectomy reduces cancer–specific survival. BJU Int. 2011;108:E284–288. PubMed

Hautmann RE, Volkmer BG, Gust K. Quantification of the survival benefit of early versus deferred cystectomy in high–risk non–muscle invasive bladder cancer (T1 G3) World J Urol. 2009;27:347–351. PubMed

Denzinger S, Fritsche HM, Otto W, Blana A, Wieland WF, Burger M. Early versus deferred cystectomy for initial high–risk pT1G3 urothelial carcinoma of the bladder: do risk factors define feasibility of bladder–sparing approach? Eur Urol. 2008;53:146–152. PubMed

Herr HW, Sogani PC. Does early cystectomy improve the survival of patients with high risk superficial bladder tumors? J Urol. 2001;166:1296–1299. PubMed

Konety BR, Dhawan V, Allareddy V, Joslyn SA. Impact of hospital and surgeon volume on in–hospital mortality from radical cystectomy: data from the health care utilization project. J Urol. 2005;173:1695–1700. PubMed

Konety BR, Dhawan V, Allareddy V, O'Donnell MA. Association between volume and charges for most frequently performed ambulatory and nonambulatory surgery for bladder cancer. Is more cheaper? J Urol. 2004;172:1056–1061. PubMed

Birkmeyer JD, Stukel TA, Siewers AE, Goodney PP, Wennberg DE, Lucas FL. Surgeon volume and operative mortality in the United States. N Engl J Med. 2003;349:2117–2127. PubMed

Birkmeyer JD, Siewers AE, Finlayson EV, Stukel TA, Lucas FL, Batista I, et al. Hospital volume and surgical mortality in the United States. N Engl J Med. 2002;346:1128–1137. PubMed

Miller DC, Taub DA, Dunn RL, Montie JE, Wei JT, et al. The impact of co–morbid disease on cancer control and survival following radical cystectomy. J Urol. 2003;169:105–109. PubMed

Hautmann RE, Paiss T. Does the option of the ileal neobladder stimulate patient and physician decision toward earlier cystectomy? J Urol. 1998;159:1845–1850. PubMed

Adamowicz J, Kowalczyk T, Drewa T. Tissue engineering of urinary bladder – current state of art and future perspectives. Cent European J Urol. 2013;66:202–206. PubMed PMC

Optimized management in patients with bladder cancer