Factors associated with utilization of neoadjuvant chemotherapy in charlson comorbidity zero non-metastatic muscle-invasive bladder cancer patients

Oncological outcomes of visibly complete transurethral resection prior to neoadjuvant chemotherapy for bladder cancer

PURPOSE

To evaluate the potential oncologic benefit of a visibly complete transurethral resection of a bladder tumor (TURBT) prior to neoadjuvant chemotherapy (NAC) and radical cystectomy (RC).

MATERIALS AND METHODS

We identified patients who received NAC and RC between 2011-2021. Records were reviewed to assess TURBT completeness. The primary outcome was pathologic downstaging (

RESULTS

We identified 153 patients, including 116 (76%) with a complete TURBT. Sixty-four (42%) achieved

CONCLUSIONS

A visibly complete TURBT was not associated with pathologic downstaging, cancer-specific or recurrence-free survival following NAC and RC. These data do not support the need for repeat TURBT to achieve a visibly complete resection if NAC and RC are planned.

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Key Words

• Cystectomy
• Neoadjuvant Therapy
• Transurethral Resection of Bladder

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MESH Headings

• Humans
• Treatment Outcome
• Neoadjuvant Therapy
• Urinary Bladder Neoplasms/drug therapy
• Urinary Bladder Neoplasms/surgery
• Urinary Bladder Neoplasms/pathology
• Urologic Surgical Procedures
• Cystectomy
• Retrospective Studies
• Neoplasm Invasiveness

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Affiliation(s)

Bryce Baird Mayo ClinicDepartment of UrologyJacksonvilleFLUSADepartment of Urology Mayo Clinic, Jacksonville, FL, USA
Ahmet Bilgili Mayo ClinicDepartment of UrologyJacksonvilleFLUSADepartment of Urology Mayo Clinic, Jacksonville, FL, USA
Augustus Anderson Tulane UniversitySchool of MedicineNew OrleansLAUSATulane University School of Medicine, New Orleans, LA, USA
Gianpiero Carames University of AlabamaDepartment of PathologyBirminghamALUSADepartment of Pathology, University of Alabama at Birmingham, Birmingham, AL, USA
Ram A. Pathak Mayo ClinicDepartment of UrologyJacksonvilleFLUSADepartment of Urology Mayo Clinic, Jacksonville, FL, USA
Colleen T. Ball Mayo ClinicDepartment of Quantitative Health SciencesJacksonvilleFLUSADepartment of Quantitative Health Sciences, Mayo Clinic, Jacksonville, FL, USA
Raymond Pak Mayo ClinicDepartment of UrologyJacksonvilleFLUSADepartment of Urology Mayo Clinic, Jacksonville, FL, USA
Andrew Zganjar Mayo ClinicDepartment of UrologyJacksonvilleFLUSADepartment of Urology Mayo Clinic, Jacksonville, FL, USA
Paul R. Young Mayo ClinicDepartment of UrologyJacksonvilleFLUSADepartment of Urology Mayo Clinic, Jacksonville, FL, USA
Timothy D. Lyon Mayo ClinicDepartment of UrologyJacksonvilleFLUSADepartment of Urology Mayo Clinic, Jacksonville, FL, USA

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Access to urologists for participation in research: An analysis of NCI's Community Oncology Research Program landscape survey

Purpose

Urological cancer clinical trials face accrual challenges, which may stem from structural barriers within cancer programs. We sought to describe the extent to which urology cancer care providers are available within community cancer research programs and explore the role of oncology practice group ownership in their access to urology practices to participate in research.

Materials and methods

We conducted secondary analysis of organizational survey data collected in 2017 among National Cancer Institute Community Oncology Research Program practice groups. We used logistic regression to assess the association of self-reported access to urologists to participate in research and oncology practice group ownership type: independent, payor-provider, health-system, or public ownership.

Results

Of the 209 community oncology practice groups in the analysis sample, 133 (63.6%) had access to urologists for research participation. Ownership was not statistically significantly associated with access to urology practices after controlling for other covariates (p = 0.4). Instead, having a hospital outpatient clinic (p = 0.008) and identifying as a safety-net hospital (p = 0.035) were both positively significantly associated with access to urologists to participate in research.

Conclusions

Two-thirds of community cancer research groups have access to urology. Oncology ownership status was not associated with access to urologists for research. Research groups may need support to increase their capacity to engage non-oncology cancer care providers in research.