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Query: UMLS:C0027627 (metastases)
 103,950 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Bladder tumors morphological and treatment efficacy data obtained on 246 relevant patients over 60 years of age support the benefit of surgery in combined treatment of bladder cancer in elderly patients in spite of difficulties caused by concomitant diseases and defective adaptation. High-grade poorly differentiated cancer of the bladder causing more frequent recurrences and metastases occur in patients over 60 two times less often than in younger patients. Transurethral electroresection of the bladder with removal of the tumor followed by intravesical immunoprophylaxis of the recurrences is thought a radical treatment for elderly patients with bladder cancer stage T1 and T2. At stage T3 cystectomy is preferable. Positioning of the ureters into the straight ileocecal angle provides the best results in urine derivation after cystectomy. Transurethral electroresection is optimal in the treatment of elderly patients with bladder cancer stage T1-T2 and prostatic adenoma. Indications to transurethral adenomectomy in the presence of bladder cancer must be maximally extended as adenomatous nodes provoke infravesical obstruction and speed up the recurrence of bladder cancer.
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PMID:[The surgical treatment of patients with bladder cancer in middle and old age]. 912 60

Studies on outcomes in bladder cancer rely on accurate methods to identify patients with bladder cancer and differentiate bladder cancer stage. Medical record and administrative databases are increasingly used to study cancer incidence, but few have distinguished cancer stage, and none have focused on bladder cancer. In this study, we used data from The UK Health Improvement Network (THIN) to identify patients with bladder cancer using at least one diagnostic code for bladder cancer, and distinguish muscle-invasive from non-invasive disease using a subsequent code for cystectomy. Algorithms were validated against a gold standard of physician-completed questionnaires, pathology reports, and consultant letters. Algorithm performance was evaluated by measuring positive predictive value (PPV) and corresponding 95% confidence interval (CI). Among all patients coded with bladder cancer (n = 194), PPV for any bladder cancer was 99.5% (95% CI, 97.2-99.9). PPV for incident bladder cancer was 93.8% (95% CI, 89.4-96.7). PPV for muscle-invasive bladder cancer was 70.1% (95% CI, 59.4-79.5) in patients with cystectomy (n = 95) and 83.9% (95% CI, 66.3-94.5) in those with cystectomy plus additional codes for metastases and death (n = 31). Using our codes for bladder cancer, the age- and sex-standardized incidence rate (SIR) of bladder cancer in THIN approximated that measured by cancer registries (SIR within 20%), suggesting that sensitivity was high as well. THIN is a valid and novel database for the study of bladder cancer. Our algorithm can be used to examine the epidemiology of muscle-invasive bladder cancer or outcomes following cystectomy for patients with muscle invasion.
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PMID:Validation of a coding algorithm to identify bladder cancer and distinguish stage in an electronic medical records database. 2538 14