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Bladder Cancer
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my personal edition > bladder cancer > news
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DGReview
Diagnostic Delay Linked to Prognosis And Tumor Grade in Bladder Cancer
A DGReview of :"Diagnostic delay and prognosis in invasive bladder cancer"
Scandinavian Journal of Urology and Nephrology
11/13/2003
By Emma Hitt, PhD
Patients with T1 bladder tumours and a limited diagnostic delay demonstrate a trend towards better prognosis than do patients with muscle-invasive disease and the same limited delay, new research suggests.
According to the researchers, diagnostic delay can be classified as the patient's delay, i.e., the time lag from the patient's awareness of symptoms to the first medical consultation, and the doctor's delay, i.e., the time lag from that consultation to the establishment of a correct diagnosis. Studies evaluating the consequences of diagnostic delay in bladder cancer have produced conflicting results.
Previously, 177 patients with invasive bladder cancer (T1-T4) diagnosed in 1988 were investigated with regard to diagnostic delay and clinical records were reviewed.
In the current analysis, Fredrik Liedberg, MD, with the Lund University Hospital, Sweden, and colleagues, analysed these patients' causes of death, which were registered over a 12-year follow-up period, and evaluated the impact of diagnostic delay on bladder cancer death.
Median diagnostic delay was 144 days, they report. When the patients were stratified into groups with diagnostic delays of 0-3, 3-6, 6-12 and more than 12 months, those with T1 tumours and a diagnostic delay of less than 6 months showed a trend towards a decreased risk of bladder cancer death.
In contrast, in patients with muscle-invasive disease, a significantly increased risk of bladder cancer death was noted for those with a diagnostic delay of less than 6 months.
"The poor prognosis of patients with muscle-invasive disease and a short diagnostic delay suggests aggressive behaviour of the tumour and may explain the worse prognosis in these patients," the researchers conclude.
"The fact that T1 tumours with a short diagnostic delay had a better prognosis, while T2-T4 tumours with a short diagnostic delay had a worse outcome suggests heterogeneity among bladder tumours, making the outcome of screening uncertain," they add.
Scand J Urol Nephrol 2003;37:5:396-400.
"Diagnostic delay and prognosis in invasive bladder cancer"
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