Information on bladder cancer (BC) according to the subtype of tumors in a general population is scarce despite its clinical relevance. The objective was to describe the characteristics of incident BC in a general population, with a focus on the initial management of high-risk non-muscle invasive BC (HR-NMIBC) given the unfavorable evolution these cases may take.
BC incident in 2011-2012 registered in a population-based cancer registry were studied. Data was extracted from the medical files. NMIBC were classified according to potential risk for recurrence/progression. Individual and tumor characteristics of incident BC were described. Incidence, initial management and survival (12/31/2021) of HR-NMIBC were assessed.
Among 538 BC cases, 380 were NMIBC (119 low (22.1%), 163 intermediate (30.3%), 98 high (18.2%) risk) and 147 (27.3%) were MIBC. HR-NMIBC diagnostic and therapeutic management (imaging, re-TUR, multi-disciplinary team meetings (MDT) assessment, specific treatment) revealed discrepancies with guidelines recommendations. Seventy-two out of 98 cases were assessed during an MDT with a median time from diagnosis of 18 days [First quartile:12-third quartile:32]. Treatment agreed with MDT decisions globally. Intravesical instillation was the most common treatment (n=56) but 27 HR-NMIBC did not receive specific treatment after TUR. Five and 10 years overall survival was 52%[42-63] and 41%[31-51] respectively. Five years net survival was 63%[47-75].
Despite National cancer plans aiming at improving care giving and despite the severity of HR-NMIBC, guideline-recommended patterns of care were underused in this region. This may deserve attention to identify obstacles to guideline adoption to try to improve BC patient care and survival.
The French journal of urology. 2024 Jul 03 [Epub ahead of print]
Fabien Saint, David Pasquier, Arnauld Villers, Jordan Massa, Pierre Colin, Olivier Vankemmel, Xavier Leroy, Jean-Louis Bonnal, Sandrine D Plouvier
Univ. Lille, CHU Lille, Department of Urology, F-59000 Lille, France; EPROAD Laboratory EA 4669, Picardie Jules Verne University, France., Academic Department of Radiation Oncology, Centre Oscar Lambret, Lille, France; Université de Lille, CRIStAL UMR 9189, Lille, France., Univ. Lille, CHU Lille, Department of Urology, F-59000 Lille, France., Service d'urologie, Hôpital Privé La louvière, 59800 Lille, France., Hôpital Privé le Bois, Lille, France., Univ. Lille, CHU Lille, Department of Pathology, F-59000 Lille, France., Service d'Urologie, Groupement des hôpitaux de l'Institut catholique de Lille, Université Nord de France., General Cancer Registry of Lille area, C2RC, Lille, France. Electronic address: .