UNASSIGNED: 272 Background: Over 17,000 @entity1 are diagnosed with @entity150 ( @entity150 ) in the United States each year. Despite its lethal potential, emerging data has suggested that many @entity1 do not receive aggressive therapy consistent with established practice standards. Using data from American College of Surgeons Commission on @entity5 accredited facilities, we seek to characterize treatment patterns for @entity1 with @entity150 according to demographic, clinical, pathologic and facility variables. METHODS: 28,691 adult @entity1 diagnosed with @entity150 (stages II-IV), excluding those with T4b @entity5 or distant metastases between 2004 and 2008 were selected for analyses from the National @entity5 Database. Treatments included radical or partial cystectomy +/- chemotherapy (CT), chemoradiotherapy (CRT), radiotherapy (RT) or CT alone and surveillance. @entity146 ( @entity146 ) was defined as any open surgery or RT with a total dose >= 50 Gy. Determinants of @entity146 were assessed by multivariate generalized estimating equations accounting for facility clustering. RESULTS: 52.5% of @entity1 received @entity146 (45% were treated surgically while 7.5% received CRT or RT), 11.7% received palliative CT or RT, and 25.9% received surveillance only. Receipt of @entity146 decreased significantly with advancing age (OR 0.29 for age >80 vs. 18-59, p<.001). @entity146 was also received less frequently by minorities (OR 0.72 for blacks p<.001), the uninsured (OR 0.72, p<.001), Medicaid-insured @entity1 (OR 0.81, p=.006) and by those @entity1 treated at low-volume centers (OR 0.63 vs. high-volume, p<.001). Receipt of @entity146 increased with more advanced stage (OR 2.33 for stage III vs. stage II, p<.001) and in @entity1 with non-urothelial histology (OR 1.32 and 1.50 for squamous and @entity420 histology respectively, p<.001). @entity3041 was associated with decreased use of @entity146 (OR 0.70, p<.001). CONCLUSIONS: Aggressive therapies for @entity150 are received less frequently by the elderly and those with historically poorer socioeconomic status. These data indicate a significant unmet clinical need for physician education regarding appropriate selection of @entity1 for cystectomy and RT-based bladder sparing therapy.

Receipt of aggressive therapies for XXXX : Results from the National @entity5 Data Base.

@entity1 :: ('9606', 'Species') :: ['patients'] @entity146 :: ('MESH:D001523', 'Disease') :: ['Aggressive therapy', 'AT'] @entity5 :: ('MESH:D009369', 'Disease') :: ['Cancer', 'tumors'] @entity3041 :: ('MESH:D006869', 'Disease') :: ['Hydronephrosis'] @entity150 :: ('MESH:D001749', 'Disease') :: ['MIBC', 'muscle-invasive bladder cancer'] @entity420 :: ('MESH:D000230', 'Disease') :: ['adenocarcinoma']
@entity150 :: (MESH:D001749,Disease) :: ['muscle-invasive bladder cancer']
