The Impact of Academic Facility Type and Case Volume on Survival in Patients Undergoing Curative Radiation Therapy for Muscle-Invasive Bladder Cancer

Bajaj, Amishi; Martin, Brendan; Bhasin, Richa; Hentz, Courtney; Block, Alec M.; Harkenrider, Matthew M.

doi:10.1016/j.ijrobp.2017.11.040

Cited by 18 publications

(22 citation statements)

References 19 publications

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“…There is also the possibility that patients initially seen at lower volume centers were referred to institutes with more experience with bladder preservation and such patients are not identifiable in our analysis. Additionally, our results are in contrast to a NCDB study published in 2018 which investigated the impact of academic facility type and case volume on survival for bladder cancer patients undergoing curative intent radiation therapy [38]. These authors found that both academic facility type and case volume were not associated with survival outcomes [38].…”

Section: Discussioncontrasting

confidence: 99%

“…Additionally, our results are in contrast to a NCDB study published in 2018 which investigated the impact of academic facility type and case volume on survival for bladder cancer patients undergoing curative intent radiation therapy [38]. These authors found that both academic facility type and case volume were not associated with survival outcomes [38]. In their study, however, nearly half (48%) of the patients did not receive concurrent chemotherapy.…”

Section: Discussioncontrasting

confidence: 99%

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Impact of Facility Radiation Patient Volume on Overall Survival in Patients with Muscle Invasive Bladder Cancer Undergoing Trimodality Bladder Preservation Therapy

Fischer‐Valuck

Rudra

Gabani

et al. 2019

BLC

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Background: There is an association between higher hospital and urologist case volume and improved survival outcomes for patients with bladder cancer. Less data on facility volume and outcomes exists following trimodality bladder preservation with TURBT followed by definitive chemoradiation (CRT). Materials and Methods: The National Cancer Database was queried for patients from 2004-2013 with urothelial bladder cancer (cT2-4aN0M0) receiving definitive CRT after TURBT. We compared OS between high-and low-bladder preservation case volume (BPCV) centers using Cox proportional hazard models. BPCV was dichotomized into high versus low volume at the 70th percentile level (i.e. high volume defined as top 30th percentile of cases and low volume defined as bottom 70th percentile of cases). Propensity matching was performed to match high-and low-volume centers. Results: A total of 666 treatment facilities treating 1,635 patients with bladder preservation were identified with a median follow-up of 26 months (range, 2-136 months). A 70th percentile cutoff identified 497 patients that received treatment at 64 high-volume facilities. Median OS of patients treated at high BPCV centers was 37.0 months (95% CI, 27.3-46.7) versus 32.3 months (95% CI, 27.9-33.6) for patients treated at low BPCV centers (P = 0.004). High BPCV facilities were independently associated with a decreased hazard of death (HR, 0.86, 95% CI, 0.75-0.98; P = 0.031). In the propensity score matched cohort, median OS of patients treated at high BPCV was 36.1 months (95% CI, 26.5-45.8) versus 28.1 months (95% CI, 23.9-32.3) for patients treated at a low BPCV facility (P = 0.016). Conclusions: In this observational cohort, treatment at a high BPCV facility was associated with improved OS. Causal factors for this finding may include superior bladder specific clinician expertise, technology, and multidisciplinary-care.

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Section: Discussioncontrasting

confidence: 99%

Section: Discussioncontrasting

confidence: 99%

Impact of Facility Radiation Patient Volume on Overall Survival in Patients with Muscle Invasive Bladder Cancer Undergoing Trimodality Bladder Preservation Therapy

Fischer‐Valuck

Rudra

Gabani

et al. 2019

BLC

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“…[30][31][32][34][35][36][37][38]40,43,44 The definition for a high volume center ranged from > 3.25 to 25-66 cystectomies per year. The study by Bajaj et al 33 utilized academic vs non-academic center type as the exposure variable. They concluded that treatment with curative radiation therapy or concurrent chemoradiation therapy at an academic hospital was not associated with improved overall survival when compared to the same treatment at a non-academic hospital.…”

Section: Hospital Type and Survivalmentioning

confidence: 99%

Systematic review of the association between socioeconomic status and bladder cancer survival with hospital type, comorbidities, and treatment delay as mediators

et al. 2021

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“…201802144S; Shanghai, China). For the generation of xenografts, 1x10 6 BCa cells (in 0.1 ml PBS) were subcutaneously injected into the back of each mouse. The first batch of mice were randomly divided into the following five groups (n=3/group): i) Saline control group; ii) 5637 group; iii) 5637R group; iv) T24 group; and v) T24R group.…”

Section: Colony Formation Assaymentioning

confidence: 99%

“…In the past 20 years, as MIBC treatments have aimed to preserve the bladder and improve quality of life, radiation therapy (RT), chemotherapy for radiation sensitization, and immunotherapy have continuously improved (5). This has increased the 5-year overall survival (OS) rate to 40-50%, resulting in improved patient quality of life (6). For patients that are medically unsuitable for RC, or those who prefer non-surgical alternatives, RT and concurrent chemotherapy are currently the most effective treatments.…”

Section: Introductionmentioning

confidence: 99%

STAT3 enhances radiation-induced tumor migration, invasion and stem-like properties of bladder cancer

Wang

Mao

et al. 2020

Mol Med Rep

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Bladder cancer (BCa) is the most common cancer of the human urinary system, and is associated with poor patient prognosis and a high recurrence rate. Cancer stem cells (CSCs) are the primary cause of tumor recurrence and metastasis, possessing self-renewal properties and resistance to radiation therapy. Our previous studies indicated that phosphorylated signal transduction and transcription activator 3 (STAT3) may be a potential biomarker to predict radiation tolerance and tumor recurrence in patients with BCa, following conventional radiotherapy. The aim of the present study was to investigate the underlying mechanism of STAT3 in the radio-resistance of BCa cells. It was found that fractionated irradiation promoted the activation of two STAT3-associated CSCs signaling pathways in BCa cells, namely suppressor of variegation 3-9 homolog 1/GATA binding protein 3/STAT3 and Janus kinase 2/STAT3. Surviving cells exhibited elevated migratory and invasive abilities, enhanced CSC-like characteristics and radio-resistance. Furthermore, knockdown of STAT3 expression or inhibition of STAT3 activation markedly decreased the self-renewal ability and tumorigenicity of radiation-resistant BCa cells. Kaplan-Meier analysis revealed that decreased STAT3 mRNA levels were associated with increased overall survival times in patients with BCa. Taken together, these data indicated that STAT3 may be an effective therapeutic target for inhibiting the progression, metastasis and recurrence of BCa in patients receiving radiotherapy.

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The Impact of Academic Facility Type and Case Volume on Survival in Patients Undergoing Curative Radiation Therapy for Muscle-Invasive Bladder Cancer

Cited by 18 publications

References 19 publications

Impact of Facility Radiation Patient Volume on Overall Survival in Patients with Muscle Invasive Bladder Cancer Undergoing Trimodality Bladder Preservation Therapy

Impact of Facility Radiation Patient Volume on Overall Survival in Patients with Muscle Invasive Bladder Cancer Undergoing Trimodality Bladder Preservation Therapy

Systematic review of the association between socioeconomic status and bladder cancer survival with hospital type, comorbidities, and treatment delay as mediators

STAT3 enhances radiation-induced tumor migration, invasion and stem-like properties of bladder cancer

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