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dc.contributor.authorSörenby, Anne
dc.contributor.authorBaseckas, Gediminas
dc.contributor.authorBendahl, Pär-Ola
dc.contributor.authorBrändstedt, Johan
dc.contributor.authorHåkansson, Ulf
dc.contributor.authorNilsson, Stefan
dc.contributor.authorPatschan, Oliver
dc.contributor.authorTinzl, Martina
dc.contributor.authorWokander, Mats
dc.contributor.authorLiedberg, Fredrik
dc.contributor.authorGudjonsson, Sigurdur
dc.date.accessioned2019-06-26T12:46:54Z
dc.date.available2019-06-26T12:46:54Z
dc.date.issued2019-05-08
dc.date.submitted2019-06
dc.identifier.citationReducing recurrence in non-muscle-invasive bladder cancer by systematically implementing guideline-based recommendations: effect of a prospective intervention in primary bladder cancer patients. 2019, 1-7. doi: 10.1080/21681805.2019.1604568en_US
dc.identifier.issn2168-1813
dc.identifier.pmid31064253
dc.identifier.doi10.1080/21681805.2019.1604568
dc.identifier.urihttp://hdl.handle.net/2336/620962
dc.descriptionTo access publisher's full text version of this article click on the hyperlink belowen_US
dc.description.abstractOBJECTIVE: In non-muscle-invasive bladder cancer (NMIBC), local recurrence after transurethral resection of the bladder (TURB) is common. Outcomes vary between urological centres, partly due to the sub-optimal surgical technique and insufficient application of measures recommended in the guidelines. This study evaluated early recurrence rates after primary TURB for NMIBC before and after introducing a standardized treatment protocol. METHODS: Medical records of all patients undergoing primary TURB for NMIBC in 2010 at Skåne University Hospital, Malmö, Sweden, were reviewed. A new treatment protocol for NMIBC was defined and introduced in 2013, and results documented during the first year thereafter were compared with those recorded in 2010 prior to the intervention. The primary endpoint was early recurrence at first control cystoscopy. Comparisons were made by Chi-square analysis and Fisher's exact test. Recurrence-free survival (RFS) in the two cohorts was also investigated. RESULTS: TURB was performed on 116 and 159 patients before and after the intervention, respectively. The early recurrence rate decreased from 22% to 9.6% (p = 0.005) at the first control cystoscopy after treatment. Residual/Recurrent tumour at the first control cystoscopy after the primary TURB (i.e. at second-look resection or first control cystoscopy) decreased from 31% to 20% (p = 0.038). The proportion of specimens containing muscle in T1 tumours increased from 55% to 94% (p < 0.001). RFS was improved in the intervention group (HR = 0.65, CI = 0.43-1.0; p = 0.05). CONCLUSIONS: Introduction of a standardized protocol and reducing the number of surgeons for primary treatment of NMIBC decreased the early recurrence rate from 22% to 9.6% and lowered the recurrence incidence by 35%.en_US
dc.description.sponsorshipSwedish Cancer Society Lund Medical Faculty (ALF) Skane University Hospital Research Funds Sten K. Johnson Foundation Krapperup Foundation Skane County Council Research and Development Foundation Gosta Jonsson Research Foundation Biocareen_US
dc.language.isoenen_US
dc.publisherTaylor & Francisen_US
dc.relation.urlhttps://www.tandfonline.com/doi/abs/10.1080/21681805.2019.1604568?journalCode=isju20en_US
dc.relation.urlhttp://web.b.ebscohost.com/ehost/command/detail?vid=0&sid=6cb19df7-3cb1-4d6c-ab4b-39c1285bd769%40pdc-v-sessmgr01&bdata=JnNpdGU9ZWhvc3QtbGl2ZQ%3d%3d#jid=FSQF&db=aphen_US
dc.subjectBladder canceren_US
dc.subjectNMIBCen_US
dc.subjectguideline recommendationsen_US
dc.subjectquality of surgeryen_US
dc.subjectrecurrenceen_US
dc.subjecttransurethral resection of bladder tumour (TURB)en_US
dc.subjectKrabbameinen_US
dc.subjectÞvagblaðraen_US
dc.subjectVerklagsregluren_US
dc.subject.meshUrinary Bladder Neoplasmsen_US
dc.subject.meshClinical Protocolsen_US
dc.titleReducing recurrence in non-muscle-invasive bladder cancer by systematically implementing guideline-based recommendations: effect of a prospective intervention in primary bladder cancer patients.en_US
dc.typeArticleen_US
dc.contributor.department1 a Department of Urology , Skåne University Hospital , Malmö , Sweden. 2 b Department of Translational Medicine , Lund University , Malmö , Sweden. 3 c Division of Oncology and Pathology, Department of Clinical Sciences Lund , Lund University, Medicon Village , Lund , Sweden. 4 d Department of Urology , Landspitali University Hospital , Reykjavik , Iceland.en_US
dc.identifier.journalScandinavian journal of urologyen_US
dc.rights.accessNational Consortium - Landsaðganguren_US
dc.departmentcodeURO12
dc.source.journaltitleScandinavian journal of urology


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