Lower Tract Urothelial CancerImpact of Comorbidity on Survival of Invasive Bladder Cancer Patients, 1996-2007: A Danish Population-based Cohort Study
Section snippets
Study Population
The study population consisted of all patients with a first-time diagnosis of IBC during the 12-year period from 1996 to 2007 (International Classification of Diseases (ICD)−10 codes C69) identified in the National Patient Registry (NPR), which was established in 1977 and which has nearly complete coverage of hospital admissions countrywide.6 Only 5 places in Denmark perform radical cystectomy, which plays a central role in the management of localized or regionally advanced invasive bladder
Descriptive Data
We identified 3997 patients (2970 men and 1027 women) with a new diagnosis of IBC between 1996 and 2007. The median patient age was 72 years (range 38-96 years). The total number of incident bladder cancer patients identified during the 4 time periods 1996-1998, 1999-2001, 2002-2004, and 2005-2007 were 1048, 1018, 956, and 975 patients, respectively (Table 1).
Comorbidity
A total of 1715 patients (43%) had comorbidities. The prevalence of patients with Charlson scores of 0 decreased from 62% in 1996-1998 to
Comment
In this population-based analysis we found that more than 40% of patients with IBC also had significant comorbidities that could influence their clinical outcome. The overall survival among IBC patients decreased with increasing levels of comorbidity, though this was most profound in patients with Charlson score 3+, especially after 3 (31%-16%) and 5 (20%-11%) years of follow-up.
As with any retrospective cohort study, the quality of our data is dependent to a large degree on the ability to
Conclusions
We conclude that increasing comorbidity is associated with worse survival. The severity of comorbidities in the patients being treated for newly diagnosed invasive bladder cancer has generally increased over time; however, survival in bladder cancer patients has not appreciably altered in Denmark in recent years after adjusting for patient age, gender, and comorbidities.
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2018, European Urology OncologySystematic Review of Comorbidity and Competing-risks Assessments for Bladder Cancer Patients
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The study was supported by the Western Danish Research Forum for Health Sciences.
Other members of the Northern Danish Cancer Quality Assessment group: Tove Nilsson, Lars Dal Pedersen, Poul Bartels, Hendrik Vilstrup, Hans Peder Graversen, Anna Birthe Bach, Peder Graversen, and Erik Højkær Larsen.