title: Intravesical instillations and cancer-specific survival in patients with primary carcinoma in situ of the urinary bladder.
abstract: OBJECTIVE
  The aim of this study was to evaluate the use of intravesical treatment and cancer-specific survival of patients with primary carcinoma in situ (CIS).
  
  
  METHODS
  Data acquisition was based on the Swedish National Registry of Urinary Bladder Cancer by selecting all patients with primary CIS. The analysis covered gender, age, hospital type and hospital volume. Intravesical treatment and death due to bladder cancer were evaluated by multivariate logistic regression and multivariate Cox analysis, respectively.
  
  
  RESULTS
  The study included 1041 patients (median age at diagnosis 72 years) with a median follow-up of 65 months. Intravesical instillation therapy was given to 745 patients (72%), and 138 (13%) died from bladder cancer during the observation period. Male gender [odds ratio (OR) = 1.56, 95% confidence interval (CI) 1.13-2.17] and treatment at county (OR = 1.65, 95% CI 1.17-2.33), university (OR =2.12, 95% CI 1.48-3.03) or high-volume (OR = 1.92, 95% CI 1.34-2.75) hospitals were significantly associated with higher odds of intravesical instillations. The age category ≥80 years had a significantly lower chance of receiving intravesical therapy (OR = 0.44, 95% CI 0.26-0.74) and a significantly higher risk of dying from bladder cancer (hazard ratio = 3.03, 95% CI 1.71-5.35).
  
  
  CONCLUSIONS
  Significantly more frequent use of intravesical treatment of primary CIS was found for males and for patients treated at county, university and high-volume hospitals. Age ≥80 years was significantly related to less intravesical treatment and poorer cancer-specific survival.
authors.affiliation: a Department of Urology , Skåne University Hospital, Malmö, and Department of Translational Medicine, Lund University , Malmö , Sweden.
authors.forename: Georg
authors.initials: G
authors.lastname: Jancke
authors.affiliation: a Department of Urology , Skåne University Hospital, Malmö, and Department of Translational Medicine, Lund University , Malmö , Sweden.
authors.forename: Fredrik
authors.initials: F
authors.lastname: Liedberg
authors.affiliation: b Department of Urology , Linköping University Hospital , Linköping , Sweden.
authors.forename: Firas
authors.initials: F
authors.lastname: Aljabery
authors.affiliation: c Department of Urology , Norrland University Hospital , Umeå , Sweden.
authors.forename: Amir
authors.initials: A
authors.lastname: Sherif
authors.affiliation: d Department of Urology , Sahlgrenska University Hospital , Göteborg , Sweden.
authors.forename: Viveka
authors.initials: V
authors.lastname: Ströck
authors.affiliation: e Department of Urology , Uppsala Akademiska Hospital , Uppsala , Sweden.
authors.forename: Per-Uno
authors.initials: PU
authors.lastname: Malmström
authors.affiliation: f Department of Urology , Karolinska University Hospital , Stockholm , Sweden.
authors.forename: Abolfazl
authors.initials: A
authors.lastname: Hosseini-Aliabad
authors.affiliation: b Department of Urology , Linköping University Hospital , Linköping , Sweden.
authors.forename: Staffan
authors.initials: S
authors.lastname: Jahnson
mesh_terms: D000283:Administration, Intravesical; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000008:administration & dosage*; D001500:BCG Vaccine / Q000008:administration & dosage*; D002278:Carcinoma in Situ / Q000188:drug therapy*; D005260:Female; D005500:Follow-Up Studies; D006766:Hospitals, County / Q000706:statistics & numerical data; D061847:Hospitals, High-Volume / Q000706:statistics & numerical data; D006785:Hospitals, University / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D012042:Registries; D012737:Sex Factors; D015996:Survival Rate; D013548:Sweden; D001749:Urinary Bladder Neoplasms / Q000188:drug therapy*
chemical_list: D000970:Antineoplastic Agents; D001500:BCG Vaccine
keywords: Cancer-specific survival; intravesical treatment; primary CIS