Patterns of referral for perioperative chemotherapy among patients with muscle-invasive bladder cancer: A population-based study

被引:29
作者
Booth, Christopher M. [1 ,2 ]
Siemens, David Robert [2 ,3 ]
Peng, Yingwei [1 ,4 ]
Mackillop, William J. [1 ,2 ,4 ]
机构
[1] Queens Univ, Canc Res Inst, Div Canc Care & Epidemiol, Kingston, ON, Canada
[2] Queens Univ, Dept Oncol, Kingston, ON, Canada
[3] Queens Univ, Dept Urol, Kingston, ON, Canada
[4] Queens Univ, Dept Publ Hlth Sci, Kingston, ON, Canada
基金
加拿大创新基金会;
关键词
Bladder cancer; Quality of care; Chemotherapy; Surgery; Health services research; Knowledge translation; ADJUVANT CHEMOTHERAPY; NEOADJUVANT CHEMOTHERAPY; CYSTECTOMY; CARE;
D O I
10.1016/j.urolonc.2014.05.012
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Purpose: Reasons for low uptake of perioperative chemotherapy for muscle-invasive bladder cancer are not well described. Herein, we report referral patterns from urology to medical oncology (MO) in Ontario, Canada, and subsequent use of chemotherapy. Methods: Electronic treatment records were linked to the Ontario Cancer Registry to describe referral patterns and use of neoadjuvant/ adjuvant chemotherapy (NACT/ACT) among patients with muscle-invasive bladder cancer treated with cystectomy in Ontario from 1994 to 2008. Logistic regression identified factors associated with referral to MO and use of NACT/ACT. Results: Overall, 18% (520/2,944) of patients were seen by MO before cystectomy, and 25% (128/520) of referred cases were treated with NACT. Among patients not treated with NACT or radiation, 39% (1,085/2,809) were seen by MO following cystectomy; 51% (548/ 1,085) of referred patients had ACT. There was wide geographic variation in MO referral rates before (range: 5%-40%) and after cystectomy (range: 26%-59%). Patients seen by MO from 2004 to 2008 were more likely to receive ACT (57%) compared with patients in earlier years (41% in 1994-1998 and 46% in 1999-2003, P < 0.001). Conclusions: Lack of referral to MO is an important barrier to use of NACT/ACT. Upstream decision making by urologists is an important target in future knowledge translation. (C) 2014 Elsevier Inc. All rights reserved.
引用
收藏
页码:1200 / 1208
页数:9
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