Enhancing bladder cancer care through the multidisciplinary clinic approach

Area of Science:

• Oncology
• Urology
• Cancer Care Delivery Models

Background:

• Muscle invasive bladder cancer (MIBC) requires comprehensive treatment strategies.
• Multidisciplinary care models integrate various specialists for optimal patient management.
• The Sidney Kimmel Cancer Center has a long-standing multidisciplinary genitourinary oncology clinic (MDC).

Purpose of the Study:

• To evaluate the 25-year impact of a multidisciplinary care delivery model on MIBC patients.
• To compare outcomes of MIBC patients treated within an NCI-designated center's MDC versus national SEER data.
• To assess the utilization of neoadjuvant therapies and radical cystectomy rates in MIBC patients.

Main Methods:

• Retrospective analysis of 91 MIBC patients (cT2-4 N0-1 M0) treated at the Sidney Kimmel Cancer Center MDC (2016-2019).
• Comparison with 8675 MIBC patients from the SEER-18 database (2015-2017) with similar staging.
• Outcomes assessed included radical cystectomy completion, neoadjuvant therapy use, and survival.

Main Results:

• MDC patients had significantly higher radical cystectomy rates (65.9% vs. 37.7%, p < 0.001) compared to SEER data.
• Neoadjuvant therapy use was higher in MDC patients (71.8%) than reported national trends.
• MDC patients demonstrated significantly better cancer-specific survival (mean 20.4 vs. 18.3 months, p = 0.028).

Conclusions:

• A sustained multidisciplinary care model for MIBC leads to increased utilization of radical cystectomy and neoadjuvant therapies.
• This integrated approach significantly improves cancer-specific survival for bladder cancer patients.
• The findings support the long-term efficacy of specialized multidisciplinary clinics in managing complex genitourinary malignancies.