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Open Access 01-04-2020 | Hematuria | Original Article

Symptoms and diagnostic delays in bladder cancer with high risk of recurrence: results from a prospective FinnBladder 9 trial

Authors: Ville Sell, Otto Ettala, Ileana Montoya Perez, Riikka Järvinen, Tarmo Pekkarinen, Markku Vaarala, Marjo Seppänen, Tapani Liukkonen, Timo Marttila, Sirpa Aaltomaa, Eero Kaasinen, Peter J. Boström

Published in: World Journal of Urology | Issue 4/2020

Abstract

Purpose

To investigate the symptoms and delays in the clinical pathway of bladder cancer (BC).

Methods

This is a substudy of a prospective, randomized, multicenter phase III study (FinnBladder 9, NCT01675219) where the efficacy of photodynamic diagnosis and 6 weekly optimized mitomycin C instillations are studied in pTa bladder cancer with high risk for recurrence. The data of presenting symptoms and critical time points were prospectively collected, and the effect of factors on delays was analyzed.

Results

At the time of analysis, 245 patients were randomized. Analysis included 131 patients with primary bladder cancer and their complete data. Sixty-nine percent had smoking history and 67% presented with macroscopic hematuria. Median patient delay (from symptoms to health-care contact) was 7 days. The median general practice delay (from health-care contact to urology referral) was 8 days. Median time from urology referral to cystoscopy was 23 days and from cystoscopy to TUR-BT 21 days. Total time used in the clinical pathway (from symptom to TUR-BT) was 78 days. Current and former smokers had non-significantly shorter patient-related and general practice delays compared to never smokers. TUR-BT delay was significantly shorter in patients with malignant cytology (16 days) compared to patients with benign cytology (21 days, p = 0.03).

Conclusions

Patient-derived delay was short and most of the delay occurred in the referral centers. The majority had macroscopic hematuria as the initial symptom. Surprisingly, current and past smokers were more prone to contact the health-care system compared to never smokers.

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Title: Symptoms and diagnostic delays in bladder cancer with high risk of recurrence: results from a prospective FinnBladder 9 trial
Authors: Ville Sell
Otto Ettala
Ileana Montoya Perez
Riikka Järvinen
Tarmo Pekkarinen
Markku Vaarala
Marjo Seppänen
Tapani Liukkonen
Timo Marttila
Sirpa Aaltomaa
Eero Kaasinen
Peter J. Boström
Publication date: 01-04-2020
Publisher: Springer Berlin Heidelberg
Keyword: Hematuria
Published in: World Journal of Urology / Issue 4/2020
Print ISSN: 0724-4983
Electronic ISSN: 1433-8726
DOI: https://doi.org/10.1007/s00345-019-02841-4

At a glance: The STEP trials

Springer Medicine

Symptoms and diagnostic delays in bladder cancer with high risk of recurrence: results from a prospective FinnBladder 9 trial

Abstract

Purpose

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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