Delay in bladder cancer surgery decreases survival

Bladder cancer patients whose surgery was delayed more than 3 months after diagnosis were more likely to die from their disease than were patients whose surgery was performed sooner, according to a recent study by researchers at the University of Michigan Comprehensive Cancer Center, Ann Arbor.

The study, published in the Journal of Urology (2006; 175:1262-7), followed 214 patients diagnosed with muscle-invasive bladder cancer and treated with radical cystectomy. Thirty-nine percent of patients without a 93-day delay to surgery died compared with 54% of patients whose surgery was delayed more than 93 days. The patients whose surgery was delayed lived only 1 year on average, and their 3-year survival rate was 38%, compared with the 3-year survival rate of 51% for patients whose surgery was not delayed.

The most common reason for delay was scheduling issues. Less-frequent reasons were patients seeking multiple opinions, misdiagnosis, or patients reluctant to be treated.

“Most of these causes for delaying surgery are potentially reversible, and physicians-despite busy schedules and the need for second opinions-need to be diligent about coordinating appointments and information in a timely way,” said lead author Cheryl Lee, MD.