Discrepancy between clinical and pathological stage: external validation of the impact on prognosis in an international radical cystectomy cohort
Study Type – Prognosis (case series) Level of Evidence 4 What’s known on the subject? and What does the study add? Observations from small retrospective studies have indicated that a considerable number of patients undergoing radical cystectomy for bladder cancer experience a stage migration (either...
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| Veröffentlicht in: | BJU international 2011-03, Vol.107 (6), p.898-904 |
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| creator | Svatek, Robert S. Shariat, Shahrokh F. Novara, Giacomo Skinner, Eila C. Fradet, Yves Bastian, Patrick J. Kamat, Ashish M. Kassouf, Wassim Karakiewicz, Pierre I. Fritsche, Hans‐Martin Izawa, Jonathan I. Tilki, Derya Ficarra, Vincenzo Volkmer, Bjoern G. Isbarn, Hendrik Dinney, Colin P. |
| description | Study Type – Prognosis (case series) Level of Evidence 4
What’s known on the subject? and What does the study add?
Observations from small retrospective studies have indicated that a considerable number of patients undergoing radical cystectomy for bladder cancer experience a stage migration (either upstaging or downstaging) when comparing clinical and pathological staging. In addition, it is unclear if pathological upstaging is an adverse prognostic feature independent of pathological stage.
We report the frequency of upstaging and downstaging using a large, international multicentre cohort of patients undergoing radical cystectomy for bladder cancer without neoadjuvant chemotherapy. Our findings indicate that pathological upstaging is not an independent adverse prognostic feature when considering pathological stage.
OBJECTIVE
• To compare the clinical and pathologic stage among a large, multi‐institutional series of patients undergoing radical and to determine the effect of stage discrepancy on outcomes.
PATIENTS AND METHODS
• Data was collected from nine centers and 3,393 patients with urothelial carcinoma of the bladder (UCB) treated with radical cystectomy and pelvic lymphadenectomy without neo‐adjuvant chemotherapy.
• A retrospective cohort design was used to assess the percentage of patients experiencing stage discrepancy and the impact of stage discrepancy on time to disease relapse and time to death from UCB.
RESULTS
• Clinical under staging occurred in 50% of patients and pathologic down staging occurred in 18% of patients.
• Up staging to muscle invasive disease occurred in 45.9% (n = 592) of 1,291 patients with clinical ≤T1, including 30.6% of patients with Tis only at transurethral resection.
• Of the 3,166 patients with clinically organ confined (OC) tumor stage, 1,357 (42.9%) were up staged to non‐organ confined pathologic tumor stage.
• Within each clinical stage stratum, patients who were clinically under staged had a higher probability of disease relapse or death from UCB compared to those who were same staged or down staged on pathologic examination (P |
| doi_str_mv | 10.1111/j.1464-410X.2010.09628.x |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_863426070</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>863426070</sourcerecordid><originalsourceid>FETCH-LOGICAL-c4488-8c97c95daed976053d558aa87f88fc2818ebb9b9bf8f574573f2072f005236313</originalsourceid><addsrcrecordid>eNqNUcuOFCEUJUbjPPQXDBvjqlveRZm4cEbHRyZx4yTuCE1BN50qKIF2uj7DP5bq7hm3QgKXe8-53JwDAMRoiet6u11iJtiCYfRzSVDNolYQudw_AeePhacPca2dgYuctwjVhODPwRnBhDGB2Dn489Fnk-yog5ngypZ7awM0vQ_e6B7q0MFRl03s4_qQyEWv7Tto98WmUN-_de87XXwMMDpYNhb6YdSmwJoYU1yHmH2GPtRO9TyQZnBlJt0dOpopF2tKHCZo4iam8gI8c7rP9uXpvgR3N59-XH9Z3H7__PX6w-3CMCblQpq2MS3vtO3aRiBOO86l1rJxUjpDJJZ2tWrrdtLxhvGGOoIa4hDihAqK6SV4c-xb5_y1s7mooUph-14HG3dZSUEZEahBFSmPSJNizsk6NSY_6DQpjNTsh9qqWWo1y65mP9TBD7Wv1FenT3arwXaPxAcDKuD1CaBzlcOlaoTP_3C0FZhzWnHvj7h739vpvwdQV9_u5oj-BbdnqYg</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>863426070</pqid></control><display><type>article</type><title>Discrepancy between clinical and pathological stage: external validation of the impact on prognosis in an international radical cystectomy cohort</title><source>MEDLINE</source><source>Wiley Online Library Journals Frontfile Complete</source><creator>Svatek, Robert S. ; Shariat, Shahrokh F. ; Novara, Giacomo ; Skinner, Eila C. ; Fradet, Yves ; Bastian, Patrick J. ; Kamat, Ashish M. ; Kassouf, Wassim ; Karakiewicz, Pierre I. ; Fritsche, Hans‐Martin ; Izawa, Jonathan I. ; Tilki, Derya ; Ficarra, Vincenzo ; Volkmer, Bjoern G. ; Isbarn, Hendrik ; Dinney, Colin P.</creator><creatorcontrib>Svatek, Robert S. ; Shariat, Shahrokh F. ; Novara, Giacomo ; Skinner, Eila C. ; Fradet, Yves ; Bastian, Patrick J. ; Kamat, Ashish M. ; Kassouf, Wassim ; Karakiewicz, Pierre I. ; Fritsche, Hans‐Martin ; Izawa, Jonathan I. ; Tilki, Derya ; Ficarra, Vincenzo ; Volkmer, Bjoern G. ; Isbarn, Hendrik ; Dinney, Colin P.</creatorcontrib><description>Study Type – Prognosis (case series) Level of Evidence 4
What’s known on the subject? and What does the study add?
Observations from small retrospective studies have indicated that a considerable number of patients undergoing radical cystectomy for bladder cancer experience a stage migration (either upstaging or downstaging) when comparing clinical and pathological staging. In addition, it is unclear if pathological upstaging is an adverse prognostic feature independent of pathological stage.
We report the frequency of upstaging and downstaging using a large, international multicentre cohort of patients undergoing radical cystectomy for bladder cancer without neoadjuvant chemotherapy. Our findings indicate that pathological upstaging is not an independent adverse prognostic feature when considering pathological stage.
OBJECTIVE
• To compare the clinical and pathologic stage among a large, multi‐institutional series of patients undergoing radical and to determine the effect of stage discrepancy on outcomes.
PATIENTS AND METHODS
• Data was collected from nine centers and 3,393 patients with urothelial carcinoma of the bladder (UCB) treated with radical cystectomy and pelvic lymphadenectomy without neo‐adjuvant chemotherapy.
• A retrospective cohort design was used to assess the percentage of patients experiencing stage discrepancy and the impact of stage discrepancy on time to disease relapse and time to death from UCB.
RESULTS
• Clinical under staging occurred in 50% of patients and pathologic down staging occurred in 18% of patients.
• Up staging to muscle invasive disease occurred in 45.9% (n = 592) of 1,291 patients with clinical ≤T1, including 30.6% of patients with Tis only at transurethral resection.
• Of the 3,166 patients with clinically organ confined (OC) tumor stage, 1,357 (42.9%) were up staged to non‐organ confined pathologic tumor stage.
• Within each clinical stage stratum, patients who were clinically under staged had a higher probability of disease relapse or death from UCB compared to those who were same staged or down staged on pathologic examination (P < 0.05).
CONCLUSIONS
• We identified clinical under staging in half of the patients undergoing radical cystectomy for UCB.
• Up staging resulted in a higher likelihood of disease progression and eventual death from UCB.
• These findings should be considered when utilizing pre‐operative risk‐adapted strategies for selecting candidates for neoadjuvant chemotherapy.</description><identifier>ISSN: 1464-4096</identifier><identifier>EISSN: 1464-410X</identifier><identifier>DOI: 10.1111/j.1464-410X.2010.09628.x</identifier><identifier>PMID: 21244604</identifier><language>eng</language><publisher>Oxford, UK: Blackwell Publishing Ltd</publisher><subject>Adult ; Aged ; Aged, 80 and over ; Biological and medical sciences ; bladder cancer ; Cystectomy - methods ; discrepancy ; Epidemiologic Methods ; Female ; Humans ; Male ; Medical sciences ; Middle Aged ; migration ; Neoplasm Recurrence, Local ; Neoplasm Staging - standards ; Nephrology. Urinary tract diseases ; Prognosis ; radical cystectomy ; stage ; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases ; Surgery of the urinary system ; survival ; Treatment Outcome ; Tumors of the urinary system ; Urinary Bladder Neoplasms - mortality ; Urinary Bladder Neoplasms - pathology ; Urinary Bladder Neoplasms - surgery ; Urinary tract. Prostate gland ; Young Adult</subject><ispartof>BJU international, 2011-03, Vol.107 (6), p.898-904</ispartof><rights>2011 THE AUTHORS. BJU INTERNATIONAL © 2011 BJU INTERNATIONAL</rights><rights>2015 INIST-CNRS</rights><rights>2011 THE AUTHORS. BJU INTERNATIONAL © 2011 BJU INTERNATIONAL.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4488-8c97c95daed976053d558aa87f88fc2818ebb9b9bf8f574573f2072f005236313</citedby><cites>FETCH-LOGICAL-c4488-8c97c95daed976053d558aa87f88fc2818ebb9b9bf8f574573f2072f005236313</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fj.1464-410X.2010.09628.x$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fj.1464-410X.2010.09628.x$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,27901,27902,45550,45551</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=23961553$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/21244604$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Svatek, Robert S.</creatorcontrib><creatorcontrib>Shariat, Shahrokh F.</creatorcontrib><creatorcontrib>Novara, Giacomo</creatorcontrib><creatorcontrib>Skinner, Eila C.</creatorcontrib><creatorcontrib>Fradet, Yves</creatorcontrib><creatorcontrib>Bastian, Patrick J.</creatorcontrib><creatorcontrib>Kamat, Ashish M.</creatorcontrib><creatorcontrib>Kassouf, Wassim</creatorcontrib><creatorcontrib>Karakiewicz, Pierre I.</creatorcontrib><creatorcontrib>Fritsche, Hans‐Martin</creatorcontrib><creatorcontrib>Izawa, Jonathan I.</creatorcontrib><creatorcontrib>Tilki, Derya</creatorcontrib><creatorcontrib>Ficarra, Vincenzo</creatorcontrib><creatorcontrib>Volkmer, Bjoern G.</creatorcontrib><creatorcontrib>Isbarn, Hendrik</creatorcontrib><creatorcontrib>Dinney, Colin P.</creatorcontrib><title>Discrepancy between clinical and pathological stage: external validation of the impact on prognosis in an international radical cystectomy cohort</title><title>BJU international</title><addtitle>BJU Int</addtitle><description>Study Type – Prognosis (case series) Level of Evidence 4
What’s known on the subject? and What does the study add?
Observations from small retrospective studies have indicated that a considerable number of patients undergoing radical cystectomy for bladder cancer experience a stage migration (either upstaging or downstaging) when comparing clinical and pathological staging. In addition, it is unclear if pathological upstaging is an adverse prognostic feature independent of pathological stage.
We report the frequency of upstaging and downstaging using a large, international multicentre cohort of patients undergoing radical cystectomy for bladder cancer without neoadjuvant chemotherapy. Our findings indicate that pathological upstaging is not an independent adverse prognostic feature when considering pathological stage.
OBJECTIVE
• To compare the clinical and pathologic stage among a large, multi‐institutional series of patients undergoing radical and to determine the effect of stage discrepancy on outcomes.
PATIENTS AND METHODS
• Data was collected from nine centers and 3,393 patients with urothelial carcinoma of the bladder (UCB) treated with radical cystectomy and pelvic lymphadenectomy without neo‐adjuvant chemotherapy.
• A retrospective cohort design was used to assess the percentage of patients experiencing stage discrepancy and the impact of stage discrepancy on time to disease relapse and time to death from UCB.
RESULTS
• Clinical under staging occurred in 50% of patients and pathologic down staging occurred in 18% of patients.
• Up staging to muscle invasive disease occurred in 45.9% (n = 592) of 1,291 patients with clinical ≤T1, including 30.6% of patients with Tis only at transurethral resection.
• Of the 3,166 patients with clinically organ confined (OC) tumor stage, 1,357 (42.9%) were up staged to non‐organ confined pathologic tumor stage.
• Within each clinical stage stratum, patients who were clinically under staged had a higher probability of disease relapse or death from UCB compared to those who were same staged or down staged on pathologic examination (P < 0.05).
CONCLUSIONS
• We identified clinical under staging in half of the patients undergoing radical cystectomy for UCB.
• Up staging resulted in a higher likelihood of disease progression and eventual death from UCB.
• These findings should be considered when utilizing pre‐operative risk‐adapted strategies for selecting candidates for neoadjuvant chemotherapy.</description><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Biological and medical sciences</subject><subject>bladder cancer</subject><subject>Cystectomy - methods</subject><subject>discrepancy</subject><subject>Epidemiologic Methods</subject><subject>Female</subject><subject>Humans</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>migration</subject><subject>Neoplasm Recurrence, Local</subject><subject>Neoplasm Staging - standards</subject><subject>Nephrology. Urinary tract diseases</subject><subject>Prognosis</subject><subject>radical cystectomy</subject><subject>stage</subject><subject>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</subject><subject>Surgery of the urinary system</subject><subject>survival</subject><subject>Treatment Outcome</subject><subject>Tumors of the urinary system</subject><subject>Urinary Bladder Neoplasms - mortality</subject><subject>Urinary Bladder Neoplasms - pathology</subject><subject>Urinary Bladder Neoplasms - surgery</subject><subject>Urinary tract. Prostate gland</subject><subject>Young Adult</subject><issn>1464-4096</issn><issn>1464-410X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2011</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqNUcuOFCEUJUbjPPQXDBvjqlveRZm4cEbHRyZx4yTuCE1BN50qKIF2uj7DP5bq7hm3QgKXe8-53JwDAMRoiet6u11iJtiCYfRzSVDNolYQudw_AeePhacPca2dgYuctwjVhODPwRnBhDGB2Dn489Fnk-yog5ngypZ7awM0vQ_e6B7q0MFRl03s4_qQyEWv7Tto98WmUN-_de87XXwMMDpYNhb6YdSmwJoYU1yHmH2GPtRO9TyQZnBlJt0dOpopF2tKHCZo4iam8gI8c7rP9uXpvgR3N59-XH9Z3H7__PX6w-3CMCblQpq2MS3vtO3aRiBOO86l1rJxUjpDJJZ2tWrrdtLxhvGGOoIa4hDihAqK6SV4c-xb5_y1s7mooUph-14HG3dZSUEZEahBFSmPSJNizsk6NSY_6DQpjNTsh9qqWWo1y65mP9TBD7Wv1FenT3arwXaPxAcDKuD1CaBzlcOlaoTP_3C0FZhzWnHvj7h739vpvwdQV9_u5oj-BbdnqYg</recordid><startdate>201103</startdate><enddate>201103</enddate><creator>Svatek, Robert S.</creator><creator>Shariat, Shahrokh F.</creator><creator>Novara, Giacomo</creator><creator>Skinner, Eila C.</creator><creator>Fradet, Yves</creator><creator>Bastian, Patrick J.</creator><creator>Kamat, Ashish M.</creator><creator>Kassouf, Wassim</creator><creator>Karakiewicz, Pierre I.</creator><creator>Fritsche, Hans‐Martin</creator><creator>Izawa, Jonathan I.</creator><creator>Tilki, Derya</creator><creator>Ficarra, Vincenzo</creator><creator>Volkmer, Bjoern G.</creator><creator>Isbarn, Hendrik</creator><creator>Dinney, Colin P.</creator><general>Blackwell Publishing Ltd</general><general>Wiley-Blackwell</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>201103</creationdate><title>Discrepancy between clinical and pathological stage: external validation of the impact on prognosis in an international radical cystectomy cohort</title><author>Svatek, Robert S. ; Shariat, Shahrokh F. ; Novara, Giacomo ; Skinner, Eila C. ; Fradet, Yves ; Bastian, Patrick J. ; Kamat, Ashish M. ; Kassouf, Wassim ; Karakiewicz, Pierre I. ; Fritsche, Hans‐Martin ; Izawa, Jonathan I. ; Tilki, Derya ; Ficarra, Vincenzo ; Volkmer, Bjoern G. ; Isbarn, Hendrik ; Dinney, Colin P.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4488-8c97c95daed976053d558aa87f88fc2818ebb9b9bf8f574573f2072f005236313</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2011</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Biological and medical sciences</topic><topic>bladder cancer</topic><topic>Cystectomy - methods</topic><topic>discrepancy</topic><topic>Epidemiologic Methods</topic><topic>Female</topic><topic>Humans</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>migration</topic><topic>Neoplasm Recurrence, Local</topic><topic>Neoplasm Staging - standards</topic><topic>Nephrology. Urinary tract diseases</topic><topic>Prognosis</topic><topic>radical cystectomy</topic><topic>stage</topic><topic>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</topic><topic>Surgery of the urinary system</topic><topic>survival</topic><topic>Treatment Outcome</topic><topic>Tumors of the urinary system</topic><topic>Urinary Bladder Neoplasms - mortality</topic><topic>Urinary Bladder Neoplasms - pathology</topic><topic>Urinary Bladder Neoplasms - surgery</topic><topic>Urinary tract. Prostate gland</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Svatek, Robert S.</creatorcontrib><creatorcontrib>Shariat, Shahrokh F.</creatorcontrib><creatorcontrib>Novara, Giacomo</creatorcontrib><creatorcontrib>Skinner, Eila C.</creatorcontrib><creatorcontrib>Fradet, Yves</creatorcontrib><creatorcontrib>Bastian, Patrick J.</creatorcontrib><creatorcontrib>Kamat, Ashish M.</creatorcontrib><creatorcontrib>Kassouf, Wassim</creatorcontrib><creatorcontrib>Karakiewicz, Pierre I.</creatorcontrib><creatorcontrib>Fritsche, Hans‐Martin</creatorcontrib><creatorcontrib>Izawa, Jonathan I.</creatorcontrib><creatorcontrib>Tilki, Derya</creatorcontrib><creatorcontrib>Ficarra, Vincenzo</creatorcontrib><creatorcontrib>Volkmer, Bjoern G.</creatorcontrib><creatorcontrib>Isbarn, Hendrik</creatorcontrib><creatorcontrib>Dinney, Colin P.</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>BJU international</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Svatek, Robert S.</au><au>Shariat, Shahrokh F.</au><au>Novara, Giacomo</au><au>Skinner, Eila C.</au><au>Fradet, Yves</au><au>Bastian, Patrick J.</au><au>Kamat, Ashish M.</au><au>Kassouf, Wassim</au><au>Karakiewicz, Pierre I.</au><au>Fritsche, Hans‐Martin</au><au>Izawa, Jonathan I.</au><au>Tilki, Derya</au><au>Ficarra, Vincenzo</au><au>Volkmer, Bjoern G.</au><au>Isbarn, Hendrik</au><au>Dinney, Colin P.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Discrepancy between clinical and pathological stage: external validation of the impact on prognosis in an international radical cystectomy cohort</atitle><jtitle>BJU international</jtitle><addtitle>BJU Int</addtitle><date>2011-03</date><risdate>2011</risdate><volume>107</volume><issue>6</issue><spage>898</spage><epage>904</epage><pages>898-904</pages><issn>1464-4096</issn><eissn>1464-410X</eissn><abstract>Study Type – Prognosis (case series) Level of Evidence 4
What’s known on the subject? and What does the study add?
Observations from small retrospective studies have indicated that a considerable number of patients undergoing radical cystectomy for bladder cancer experience a stage migration (either upstaging or downstaging) when comparing clinical and pathological staging. In addition, it is unclear if pathological upstaging is an adverse prognostic feature independent of pathological stage.
We report the frequency of upstaging and downstaging using a large, international multicentre cohort of patients undergoing radical cystectomy for bladder cancer without neoadjuvant chemotherapy. Our findings indicate that pathological upstaging is not an independent adverse prognostic feature when considering pathological stage.
OBJECTIVE
• To compare the clinical and pathologic stage among a large, multi‐institutional series of patients undergoing radical and to determine the effect of stage discrepancy on outcomes.
PATIENTS AND METHODS
• Data was collected from nine centers and 3,393 patients with urothelial carcinoma of the bladder (UCB) treated with radical cystectomy and pelvic lymphadenectomy without neo‐adjuvant chemotherapy.
• A retrospective cohort design was used to assess the percentage of patients experiencing stage discrepancy and the impact of stage discrepancy on time to disease relapse and time to death from UCB.
RESULTS
• Clinical under staging occurred in 50% of patients and pathologic down staging occurred in 18% of patients.
• Up staging to muscle invasive disease occurred in 45.9% (n = 592) of 1,291 patients with clinical ≤T1, including 30.6% of patients with Tis only at transurethral resection.
• Of the 3,166 patients with clinically organ confined (OC) tumor stage, 1,357 (42.9%) were up staged to non‐organ confined pathologic tumor stage.
• Within each clinical stage stratum, patients who were clinically under staged had a higher probability of disease relapse or death from UCB compared to those who were same staged or down staged on pathologic examination (P < 0.05).
CONCLUSIONS
• We identified clinical under staging in half of the patients undergoing radical cystectomy for UCB.
• Up staging resulted in a higher likelihood of disease progression and eventual death from UCB.
• These findings should be considered when utilizing pre‐operative risk‐adapted strategies for selecting candidates for neoadjuvant chemotherapy.</abstract><cop>Oxford, UK</cop><pub>Blackwell Publishing Ltd</pub><pmid>21244604</pmid><doi>10.1111/j.1464-410X.2010.09628.x</doi><tpages>7</tpages><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
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| ispartof | BJU international, 2011-03, Vol.107 (6), p.898-904 |
| issn | 1464-4096 1464-410X |
| language | eng |
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| source | MEDLINE; Wiley Online Library Journals Frontfile Complete |
| subjects | Adult Aged Aged, 80 and over Biological and medical sciences bladder cancer Cystectomy - methods discrepancy Epidemiologic Methods Female Humans Male Medical sciences Middle Aged migration Neoplasm Recurrence, Local Neoplasm Staging - standards Nephrology. Urinary tract diseases Prognosis radical cystectomy stage Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases Surgery of the urinary system survival Treatment Outcome Tumors of the urinary system Urinary Bladder Neoplasms - mortality Urinary Bladder Neoplasms - pathology Urinary Bladder Neoplasms - surgery Urinary tract. Prostate gland Young Adult |
| title | Discrepancy between clinical and pathological stage: external validation of the impact on prognosis in an international radical cystectomy cohort |
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