The effect of the time interval between diagnosis of XXXX and radical cystectomy on staging and survival: A Netherlands Cancer Registry analysis.

@entity1 @entity150 @entity1349
INTRODUCTION: Data from single-center series suggest that a delay in time to radical cystectomy (RC) more than 3 months after diagnosis of @entity150 ( @entity150 ) is associated with pathological upstaging and decreased survival. However, limited data is available from population-based studies. In this study, the effect of delayed RC was assessed in a nationwide cohort. MATERIALS AND METHODS: @entity1 who underwent RC between 2006 and 2010 with primary clinical T2-T4N0M0 @entity150 were selected using the Netherlands Cancer Registry database. Data from the Netherlands Cancer Registry was supplemented with data from the Nationwide Network and Registry of Histo- and Cytopathology database in case of incomplete information. The cohort was divided in @entity1 who underwent RC  <=3 months (group I) vs. @entity1 who underwent RC >3 months (group II). Median time from @entity150 diagnosis to RC, variables associated with delayed RC >3 and the effect of delayed RC on staging and @entity1349 ( @entity1349 ) were evaluated in @entity1 who underwent neoadjuvant therapy and @entity1 who did not. RESULTS: A total of 1,782 @entity1 were included. Median follow-up time was 5.1 years for living @entity1 and 1.3 years for deceased @entity1 . Median time from @entity150 diagnosis to RC was 50 days (interquartile range: 27 days) and 93% of @entity1 underwent RC <=3 months. @entity1 older than 75 years (odds ratio [OR] = 0.50; 95% CI: 0.32-0.77), referred for RC (OR = 0.41; 95% CI: 0.26-0.69), and treated in a university hospital (OR = 0.34; 95% CI: 0.21-0.56) were less likely to undergo RC <=3 months. Pathologic upstaging rate (43.9% vs. 42.1%) and node-positive disease rate (20.2% vs. 21.7%) did not differ for group I and II. Delayed RC>3 months was not associated with decreased @entity1349 adjusting for confounding variables (hazard ratio = 1.16; 95% CI: 0.91-1.48; P = 0.25). Median time from @entity150 diagnosis to RC in @entity1 that received neoadjuvant therapy (n = 105) was 133 days (interquartile range: 62 days). Adjusting for confounding variables, delayed RC>3 months was not associated with @entity1349 (hazard ratio = 0.90; 95% CI: 0.45-1.82). CONCLUSIONS: The vast majority of @entity1 underwent RC within 3 months after diagnosis of @entity150 , as recommended in the European Association of Urology @entity150 guideline. Delayed RC for more than 3 months had no adverse effect on staging and survival.
