title: Timing of radical cystectomy in Central Europe - multicenter study on factors influencing the time from diagnosis to radical treatment of bladder cancer patients.
abstract: BACKGROUND
  Time that passes between an unfavourable diagnosis to a radical cystectomy (RC) affects oncological outcomes in patients with bladder cancer. Unsatisfactory survival of patients after RC in Central Europe can potentially result from this factor.
  
  
  METHODS
  The aim of this study was to assess the time interval between transurethral resection of the bladder tumor (TURBT) and RC in Central Europe and to identify clinical factors of possible delays. 941 consecutive patients who underwent RC in nine Central European urological centers were enrolled into the study. After the TURBT-RC time was calculated, selected clinical and pathological parameters were tested as potential factors influencing the timing of RC.
  
  
  RESULTS
  On average, RCs were performed 73.8 days after TURBTs (median - 53, range 0-1587). In 238 patients (25.3%) the time exceeded 12 weeks. Patients with muscle-invasive cancer were operated earlier on than patients with nonmuscle-invasive cancer (67.6 vs.105.2 days, RR = 1.41, p = 0.00). In high volume centers (>30 RC per year) longer TURBT-RC intervals were observed (97.6 vs. 66.3 days, RR = 2.49, p = 0.00). Simultaneously, factors such as female sex (RR = 1.21), more advanced age of patient (>65 years, RR = 1.23), presence of concomitant CIS (RR = 2.43), grade of cancer cells (RR = 1.67) and final post-RC stage (RR = 1.51) had no statistically significant effect on the results (p >0.05).
  
  
  CONCLUSIONS
  The mean time interval between the diagnosis and radical treatment of patients with bladder cancer in Central Europe is adequate. However, there are still a relatively high number of patients waiting for radical cystectomy longer than 8 weeks. A lower stage of disease as well as a higher case load within of a hospital may delay the surgery.
authors.affiliation: Medical University of Warsaw, Department of Urology, Warsaw, Poland.
authors.forename: Sławomir
authors.initials: S
authors.lastname: Poletajew
authors.affiliation: Burghele Clinical Hospital, Department of Urology, Bucharest, Romania.
authors.forename: Bogdan
authors.initials: B
authors.lastname: Braticevici
authors.affiliation: Charles University, 2nd Faculty of Medicine, Teaching Hospital in Motol, Department of Urology, Prague, Czech Republic.
authors.forename: Antonín
authors.initials: A
authors.lastname: Brisuda
authors.affiliation: Colentina Clinical Hospital, Department of Urology, Bucharest, Romania.
authors.forename: Victor
authors.initials: V
authors.lastname: Cauni
authors.affiliation: National Academy of Medical Sciences of Ukraine, Institute of Urology, Department of Restorative Urology and Newest Technology, Kyiv, Ukraine.
authors.forename: Viacheslav
authors.initials: V
authors.lastname: Grygorenko
authors.affiliation: Lviv Regional Clinical Hospital, Department of Urology, Lviv, Ukraine.
authors.forename: Martyn-Zenovii
authors.initials: MZ
authors.lastname: Lesnyak
authors.affiliation: Pomeranian Medical University, Department of Urology and Urological Oncology, Szczecin, Poland.
authors.forename: Janusz
authors.initials: J
authors.lastname: Lisiński
authors.affiliation: Carol Davila Medical University, Department of Urology, Bucharest, Romania.
authors.forename: Cristian
authors.initials: C
authors.lastname: Persu
authors.affiliation: Ceynowa Hospital, Department of Urology, Wejherowo, Poland.
authors.forename: Kacper
authors.initials: K
authors.lastname: Renk
authors.affiliation: Medical University of Warsaw, Department of Urology, Warsaw, Poland.
authors.forename: Piotr
authors.initials: P
authors.lastname: Radziszewski
keywords: bladder cancer; clinical practice pattern; cystectomy; preoperative care; time to treatment