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U.S. researchers report that patients with stage II bladder cancer, risk death from cancer and other causes if surgery was not performed within 12 weeks of diagnosis.

In the study, the researchers used the Surveillance, Epidemiology, and End Results-Medicare linked data set, a nationally representative database, to examine the impact of delayed surgery on survival of stage II bladder cancer.

The study included 441 patients with stage II bladder cancer, which is treated by radical cystectomy, complete removal of bladder, prostate and pelvic lymph node dissection.

Surgery delays of 8, 12, and 24 weeks were evaluated. The authors did not include surgeries performed within 4 weeks of diagnosis as those, they note, are likely to represent emergent cases.

By 1 year, patients who underwent surgery 12 to 24 weeks after diagnosis were 2.0- and 1.6-times as likely to have died from bladder cancer or from any cause, respectively, compared with patients treated within 4 to 8 weeks. Delays of more than 24 weeks significantly increased the risk of bladder cancer and overall mortality by 2.0-fold.
Older age and more co-existing illnesses were both significantly associated with higher overall mortality rates.

The researchers emphasize that prompt treatment was fundamental to the management of stage II bladder cancer. The care and treatment of this patient population should be designed to minimize any delay in surgery beyond 12 weeks.

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I wonder if stage II bladder cancer can be treated with chemotherapy, or something less radical. Radical cystectomy would have greatly compromised the patient's quality of life.
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