Patients with early bladder cancer who receive more intensive treatment within the first two years of diagnosis do not appear to have better survival than patients who receive less intensive treatment, according to a retrospective analysis.
Although bladder cancer is the fifth most common cancer in the Western world, optimal treatment strategies for the disease remain unclear. Current treatment guidelines favour more intense surveillance and therapy, but individual urologists vary in their approach to treatment.
The current study used the USA Surveillance, Epidemiology, and End Results database and linked patient information in the Medicare database to determine whether more intensive early treatment was associated with better outcomes. The investigators identified 20,713 patients diagnosed with early bladder cancer between 1992 and 2002. They estimated the intensity of treatment based on Medicare costs in the first two years following diagnosis and then divided the 940 treating physicians into four groups based on their average cost of treatment. It was found that more intensive treatment was not associated with better overall survival. Patients who underwent more intensive early treatment were more likely to undergo major interventions later.
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