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Elio Mazzone, Sophie Knipper, Francesco A. Mistretta, Carlotta Palumbo, Zhe Tian, Andrea Gallina, Derya Tilki, Shahrokh F. Shariat, Francesco Montorsi, Fred Saad, Alberto Briganti, and Pierre I. Karakiewicz

Background: Use of inpatient palliative care (IPC) in the treatment of advanced cancer represents a well-established guideline recommendation. A recent analysis showed that patients with genitourinary cancer benefit from IPC at the second lowest rate among 4 examined primary cancers, namely lung, breast, colorectal, and genitourinary. Based on this observation, temporal trends and predictors of IPC use were examined in patients with metastatic urothelial carcinoma of the bladder (mUCB) receiving critical care therapies (CCTs). Patients and Methods: Patients with mUCB receiving CCTs were identified within the Nationwide Inpatient Sample database (2004–2015). IPC use rates were evaluated in estimated annual percentage change (EAPC) analyses. Multivariable logistic regression models with adjustment for clustering at the hospital level were used. Results: Of 1,944 patients with mUCB receiving CCTs, 191 (9.8%) received IPC. From 2004 through 2015, IPC use increased from 0.7% to 25.0%, respectively (EAPC, +23.9%; P<.001). In analyses stratified according to regions, the highest increase in IPC use was recorded in the Northeast (EAPC, +44.0%), followed by the West (EAPC, +26.8%), South (EAPC, +22.9%), and Midwest (EAPC, +15.5%). Moreover, the lowest rate of IPC adoption in 2015 was recorded in the Midwest (14.3%). In multivariable logistic regression models, teaching status (odds ratio [OR], 1.97; P<.001), more recent diagnosis (2010–2015; OR, 3.89; P<.001), and presence of liver metastases (OR, 1.77; P=.02) were associated with higher IPC rates. Conversely, Hispanic race (OR, 0.42; P=.03) and being hospitalized in the Northeast (OR, 0.36; P=.01) were associated with lower rate of IPC adoption. Finally, patients with a primary admission diagnosis that consisted of infection (OR, 2.05; P=.002), cardiovascular disorders (OR, 2.10; P=.03), or pulmonary disorders (OR, 2.81; P=.005) were more likely to receive IPC. Conclusions: The rate of IPC use in patients with mUCB receiving CCTs sharply increased between 2004 and 2015. The presence of liver metastases, infections, or cardiopulmonary disorders as admission diagnoses represented independent predictors of higher IPC use. Conversely, Hispanic race, nonteaching hospital status, and hospitalization in the Midwest were identified as independent predictors of lower IPC use and represent targets for efforts to improve IPC delivery in patients with mUCB receiving CCT.

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Brent K. Hollenbeck, James E. Montie, and John T. Wei

Dimick JB . Potential benefits of the new Leapfrog standards: effect of process and outcomes measures . Surgery. 2004 ; 135 : 569 – 575 . 18 Stein JP Lieskovsky G Cote R . Radical cystectomy in the treatment of invasive bladder cancer

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Nalan Nese, Ruta Gupta, Matthew H. T. Bui, and Mahul B. Amin

Edited by Kerrin G. Robinson

– 2081 . 4 Koch MO Smith JA Jr . Natural history and surgical management of superficial bladder cancer (stages Ta/T1/CIS) . In: Vogelzang NJ Debruyne FM Shipley WU Scardino P , eds. Comprehensive Textbook of Genitourinary Oncology

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Venkata Pokuri, Norbert Sule, Yousef Soofi, Bo Xu, Khurshid Guru, and Saby George

/print certificate. Release date: December 16, 2013; Expiration date: December 16, 2014 Learning Objectives Upon completion of this activity, participants will be able to: Describe several treatment options for urinary bladder cancer Summarize

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Suneel D. Kamath, Sheetal M. Kircher, and Al B. Benson III

.6 billion (76.8%) of total AR. Cancers with the most NPOs were breast (13, 11%), pediatric (13, 11%), leukemia (4, 3.4%) and lung (4, 3.4%). There were no NPOs with AR >$5 M for esophageal, gastric, kidney, or bladder cancers. Cancers with the most combined

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Michael Karass, Rohan Bareja, Ethan Shelkey, Panagiotis J. Vlachostergios, Brian D. Robinson, Francesca Khani, Juan Miguel Mosquera, Douglas S. Scherr, Andrea Sboner, Scott T. Tagawa, Ana M. Molina, Olivier Elemento, David M. Nanus, and Bishoy M. Faltas

, gemcitabine/cisplatin; LNs, lymph nodes; NMIBC, non–muscle-invasive bladder cancer; RARC, robot-assisted radical cystectomy; UC, urothelial cancer. The patient was referred for systemic therapy and was enrolled in the CALGB 90601 randomized phase III trial

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Paolo Dell'Oglio, Zhe Tian, Sami-Ramzi Leyh-Bannurah, Vincent Trudeau, Alessandro Larcher, Marco Moschini, Ettore Di Trapani, Umberto Capitanio, Alberto Briganti, Francesco Montorsi, Fred Saad, and Pierre I. Karakiewicz

customarily used. 2 , 3 This index was originally developed 3 with the intent of predicting 1-year mortality in admitted medical patients. Several investigators 4 , 5 suggested the development of a comorbidity index specific to patients with bladder cancer

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Sumit Saini, Rishi Nayyar, Alpana Sharma, and Prem Nath Dogra

Objectives: Transurethral resection of bladder tumour (TURBT) is a standard procedure for both diagnosis and management of bladder cancer. Intravesical seeding of cells shed during TURBT supposedly plays an important role in tumor recurrences. This

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David D. Chism

patients diagnosed with non–muscle-invasive bladder cancer (N-MIBC), nearly a quarter experience progression to muscle-invasive bladder cancer (MIBC), which is the more aggressive phenotype. Approximately one-third of newly diagnosed patients will have MIBC

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Scott M. Gilbert and Brent K. Hollenbeck

curative resection of colon cancer: systematic review . J Natl Cancer Inst 2007 ; 99 : 433 – 441 . 3 Konety BR Joslyn SA O’Donnell MA . Extent of pelvic lymphadenectomy and its impact on outcome in patients diagnosed with bladder cancer