KEY TAKEAWAYS
- The study aimed to investigate the impact of income disparities on treatment and survival in muscle-invasive patients with bladder cancer.
- Researchers noticed that income independently influenced both treatment receipt and survival in patients with MIBC.
Muscle-invasive bladder cancer (MIBC) is a potentially fatal disease, especially in the setting of locally advanced or node-positive disease. Adverse outcomes have also primarily been associated with low-income status, as has been reported in other cancers. While the adoption of neoadjuvant cisplatin-based chemotherapy (NAC) followed by radical cystectomy (RC) and pelvic lymph node dissection (PLND) has improved outcomes, these standard-of-care treatments may be underutilized in lower-income patients.
Ryan M. Antar and the team aimed to investigate the economic disparities in NAC and PLND receipt and survival outcomes in MIBC.
They performed an inclusive analysis utilizing the National Cancer Database. A retrospective cohort analysis of cT2-4N0-3M0 patients with BC with urothelial histology who underwent radical cystectomy (RC) was conducted. The impact of income level on overall survival (OS) and the likelihood of receiving NAC and PLND was evaluated.
About 25,823 patients were included in the study. This study found that lower-income patients were less likely to receive NAC and adequate PLND (≥15 LNs). Moreover, lower-income patients exhibited worse OS (Median OS 55.9 months vs. 68.2 months, P < 0.001). Findings also demonstrated that higher income, treatment at academic facilities, and recent years of diagnosis were associated with an increased likelihood of receiving standard-of-care modalities and improved survival.
The study concluded that income independently influenced the receipt of standard MIBC treatments and survival outcomes, even after controlling for clinicodemographic variables. These findings highlight an opportunity to enhance the quality of care for lower-income MIBC patients through concerted efforts to regionalize multi-modal urologic oncology care.
The study received no external funding.
Source: https://pubmed.ncbi.nlm.nih.gov/38785473/
Antar RM, Xu VE, Adesanya O, et al. (2024). “Income Disparities in Survival and Receipt of Neoadjuvant Chemotherapy and Pelvic Lymph Node Dissection for Muscle-Invasive Bladder Cancer.” Curr Oncol. 2024 May 2;31(5):2566-2581. doi: 10.3390/curroncol31050192. PMID: 38785473; PMCID: PMC11119047.
