BACKGROUND
Bladder cancer is the third most common urological malignancy, and one of the 15 most common cancers, diagnosed in Australia. This reflects a global landscape in which it is the most common urological malignancy and responsible for over 400,000 diagnoses and around 165,000 deaths per year.1-3 Despite changing treatment paradigms, survival outcomes have ostensibly remained consistent over the last 30 years. In particular, there is little recent research focused on regionally and rurally based bladder cancer patient cohort, access to standard-of-care and other treatment, and outcomes.
OBJECTIVE
This small-scale retrospective review study aimed to examine the sociodemographic, treatment, and survival outcome characteristics of a rurally-located cohort of patients with a diagnosis at outset of non-muscle invasive bladder cancer. As a secondary objective, the study aimed to identify future research foci and options for enhancement of clinical pathways for bladder cancer patients.
METHODS
A facility-based cross-sectional review of medical record data was undertaken, for all patients aged 18 years and over, with a diagnosis of bladder cancer and referred for BCG treatment at a regional cancer care facility, between 2010-2022. In total, 23 patients were identified. Sociodemographic and treatment-related factors were summarized as frequencies with percentages, or mean with SD. Distribution of treatment- and survival-related outcomes (recurrence-free survival, progression-free survival, overall survival) were analyzed using regression analysis and one-way ANOVA.
RESULTS
Reflecting broader trends in bladder cancer treatment and survival outcomes, a majority of the study population were male (n=18, 78%) and over the age of 60 (n=18, 78%). A weakly positive but not significant relationship was identified between: age and recurrence-free survival; and total BCG doses administered and both recurrence-free and overall survival. No correlation was observed between age and overall survival, nor sex and overall survival.
CONCLUSIONS
While the study showed some general congruence with national and global trends in bladder cancer populations, the small sample size posed significant limitations in drawing further statistical conclusions. However, this study does therefore point to the value of further research incorporating larger study population samples in rural/regional areas, with potential for attention to be paid to cross-center comparative studies. As well, it indicates the imperative to better utilize BCG as a treatment option, and to ensure that patient referral pathways facilitate early use of BCG as a known means of reducing the risk of cystectomy, and improving the chances of preservation of both the bladder and health-related quality of life. Further work to embed bladder cancer and BCG clinical pathways, as well as improved data documentation and collection for research purposes, is thus highlighted by this study.
CLINICALTRIAL
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