Background: A subset of patients with locally advanced or metastatic bladder cancer (la/mBC) do not receive systemic oncological treatment. The reasons for refraining from systemic treatment are poorly investigated, as are the characteristics of patients who turn out to be long-term survivors despite lack of treatment. Methods: This retrospective observational cohort study included patients with registration compatible with la/mBC who did not undergo systemic treatment. They were seen at a single tertiary university hospital covering one of 5 Danish regions in the study period from 1 January 2012 until 31 December 2022. Patients were identified through a coding system, and detailed patient information was obtained in the electronic medical records. Results: The initial study population consisted of 472 patients registered with la/mBC according to codes in the patient registries but with no registration of systemic oncological treatment. Out of the total cohort, 159 patients were registered correctly, while the rest of the population were excluded due to misclassification, as 10.8% did not have la/mBC and 55.5% had received oncological treatment. Among correctly registered patients, the median overall survival was 2.6 months (95% CI 0.26; 4.94) from being diagnosed with la/mBC. The most common reasons for lack of treatment were poor general condition (74.2%), patient preference (19.5%), and poor renal function (11.9%). Conclusions: Our study found that a significant amount of patients in a cohort of suspected la/mBC not undergoing treatment either received oncological treatment or did not have la/mBC, demonstrating a misclassification in the system. This should be taken into consideration when evaluating data about survival time for this patient group. The poorest survival of untreated la/mBC is associated with a high tumor burden and specifically liver metastasis.
背景：一部分局部晚期或转移性膀胱癌（la/mBC）患者未接受系统性肿瘤治疗。放弃系统性治疗的原因以及尽管未接受治疗却成为长期存活者的患者特征，目前研究尚不充分。方法：这项回顾性观察性队列研究纳入了符合la/mBC诊断登记但未接受系统性治疗的患者。研究期间为2012年1月1日至2022年12月31日，所有患者均在丹麦五个大区之一的某三级大学医院就诊。通过编码系统识别患者，并从电子病历中获取详细患者信息。结果：初始研究人群包括472名根据患者登记系统编码诊断为la/mBC但无系统性肿瘤治疗记录的患者。在总队列中，159名患者登记信息准确，其余患者因分类错误被排除——其中10.8%实际未患la/mBC，55.5%曾接受过肿瘤治疗。在正确登记的患者中，自确诊la/mBC起的中位总生存期为2.6个月（95% CI 0.26; 4.94）。未接受治疗的最常见原因包括：全身状况差（74.2%）、患者意愿（19.5%）和肾功能不全（11.9%）。结论：本研究发现，在疑似la/mBC未治疗队列中，大量患者实际接受过肿瘤治疗或并未罹患la/mBC，这表明系统中存在分类错误。在评估该患者群体的生存时间数据时应考虑此因素。未治疗的la/mBC患者生存期最短与高肿瘤负荷相关，特别是肝转移患者。
肿瘤(癌症)患者之家