title: Treatment delay and prognosis in invasive bladder cancer.
abstract: OBJECTIVE
  We studied treatment delay, and the impact on disease specific survival and stage progression in a series of patients who had undergone cystectomy.
  
  
  METHODS
  All 141 patients underwent radical cystectomy between 1990 and 1997 due to locally advanced bladder cancer. Treatment delay was defined as time from pathological confirmation of invasive disease to performance of cystectomy, and was registered retrospectively from the patient charts. Two patients received neoadjuvant chemotherapy and were excluded from further analyses. Followup continued until April 2003 with death due to bladder cancer as the end point. Causes of death were retrieved from the Swedish Cause of Death Registry.
  
  
  RESULTS
  The median treatment delay was 49 days, but was significantly longer for the 71 cases who were referred from other hospitals (63 vs 41 days, p < 0.001). Treatment delay did not influence cumulative incidence of death from bladder cancer. Considering all cases, there was no significant correlation between treatment delay and stage progression. For clinical stage T2 tumors, median treatment delay was 76 days among patients with stage progression compared to 41 and 48 days for those with stage regression and stage equivalence, respectively (p = 0.20).
  
  
  CONCLUSIONS
  Treatment delay was not found to influence disease specific survival in the present study. Furthermore, treatment delay was not significantly longer in cases that progressed compared to those with equal or lower pathological stage in the cystectomy specimen.
authors.affiliation: Department of Urology, Lund University Hospital, Lund, Sweden. fredrik.liedberg@skane.se
authors.forename: Fredrik
authors.initials: F
authors.lastname: Liedberg
authors.forename: Harald
authors.initials: H
authors.lastname: Anderson
authors.forename: Wiking
authors.initials: W
authors.lastname: Månsson
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D002295:Carcinoma, Transitional Cell / Q000401:mortality* / Q000473:pathology / Q000601:surgery*; D002423:Cause of Death; D015331:Cohort Studies; D015653:Cystectomy / Q000379:methods* / Q000401:mortality; D018572:Disease-Free Survival; D042241:Early Diagnosis; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness / Q000473:pathology*; D009367:Neoplasm Staging; D011336:Probability; D011379:Prognosis; D016016:Proportional Hazards Models; D012042:Registries; D012189:Retrospective Studies; D018570:Risk Assessment; D012737:Sex Factors; D016019:Survival Analysis; D013548:Sweden; D013997:Time Factors; D016896:Treatment Outcome; D001749:Urinary Bladder Neoplasms / Q000401:mortality* / Q000473:pathology / Q000601:surgery*