Pd06-12 Trends in Utilization and Approach to Lymph Node Dissection During Radical Nephrourerectomy for High Grade Upper Tract Urothelial Carcinoma
Year: 2017
Type: article
Study design: Observational Study
Abstract: declining treatment.58% of those included were recommended NAC but refused (n ¼ 305), while 42% of patients were not recommended NAC due to risk factors (n ¼ 219).Over the defined timeframe, an increasing trend toward patient refusal of NAC was seen (49% over 2004-2007, 59% over 2008-2010, 63% over 2011-2013, p ¼ 0.06).Many patients (58%) seen at academic or comprehensive community cancer programs did not receive NAC due to patient refusal (58% vs. 42%, p¼0.06).Patients with lower levels of education were less likely to refuse NAC, however these findings were not statistically significant.Travel distance to provider was also not associated with likelihood of patient refusal of NAC (p ¼ 0.45).No statistically significant association was found between age, gender, race, income or insurance status and the reason why NAC was not administered.CONCLUSIONS: Patient refusal of NAC prior to RC for MIBC is becoming more common.A higher education level and care received at an academic or comprehensive cancer facility was more likely to be associated with refusal of NAC, suggesting that patient counseling affects patient treatment choice prior to RC.
Source: The Journal of Urology
Language: English
Subfield: Surgery
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W2605308947