WASHINGTON, DC USA (UroToday.com) - Observational data is limited by population, and confounding variables but can be robust and useful.
SEER-Medicare is one such database and they used it to study the effectiveness of cystectomy.
They found that urbanization of cystectomy care in the 1990s resulted in a contraction of available cystectomy surgeons. They evaluated cystectomy, chemo-radiation or no further cancer-directed care (surveillance). They modeled the use of cystectomy. Only 21% with stage 2 disease underwent cystectomy. Younger age, lower comorbidities and close distance to a cystectomy provider correlated with higher odds of having a cystectomy. The unadjusted survival was significantly better among the cystectomy treated patients.
Capacity building to develop more cystectomy providers or regionalization of care might be solutions to these observations.
Presented by John Gore, MD at the Society for Basic Urologic Research (SBUR)/Society of Urologic Oncology (SUO) joint meeting during the American Urological Association (AUA) Annual Meeting - May 14 - 19, 2011 - Walter E. Washington Convention Center, Washington, DC USA
Reported for UroToday by Christopher P. Evans, MD, FACS, Professor and Chairman, Department of Urology, University of California, Davis, School of Medicine.
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