Prolonged Surgical Delay Increases Bladder Cancer Recurrence Risk

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ATLANTA—A prolonged delay between bladder cancer diagnosis and cystectomy is associated with an increased risk of disease recurrence and mortality, according to a study presented at the American Urological Association 2012 annual meeting.

Anirban P. Mitra, MD, PhD, of the Keck School of Medicine at the University of Southern California in Los Angeles, and colleagues studied 1,553 men and 411 women. The researchers observed no gender differences in the symptom-to-diagnosis interval (median delay 49 days for men, 59 days for women) or the diagnosis-to-cystectomy interval (median delay 71 days for men, 74 days for women).

In multivariate analysis, a delay in cystectomy of 11 weeks or more following diagnosis was associated with a significant 43% increased risk of recurrence and a 15% increased risk of death compared with a delay of 10 weeks or less, after controlling for age, gender, and pathologic stage. The investigators found no significant association of increasing symptom-to-diagnosis interval with cancer recurrence and overall survival.

“A prolonged diagnosis-to-cystectomy delay confers an increased risk of disease recurrence and death,” the researchers concluded in a study abstract. “Theoretically, a prolonged diagnostic delay may contribute to a delay in surgical management and the risk of pathologic upstaging at the time of cystectomy; however, a delay in diagnosis does not explain the difference in outcome generally seen in women.”

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