Due to copyright issues, an electronic copy of the thesis must be ordered from the faculty. For the faculty to have time to process the order, the order must be received by the faculty at the latest 2 days before the public defence. Orders received later than 2 days before the defence will not be processed. After the public defence, please address any inquiries regarding the thesis to the candidate.
Trial Lecture – time and place
See Trial Lecture.
Adjudication committee
- First opponent: Research Fellow Christel Häggstrøm, Umeå University, Sweden
- Second opponent: Associate Professor Stig Müller, Akershus University Hospital,
- Third member and chair of the evaluation committee: Associate Professor Morten Valberg, University of Oslo
Chair of the Defence
Professor Anette Hjartåker, University of Oslo
Principal Supervisor
Researcher Bettina Kulle Andreassen, Kreftregisteret
Summary
Muscle-invasive bladder cancer (MIBC) has a high risk of cancer spread and a poor prognosis. Curative treatment options include radical cystectomy or radical radiotherapy often combined with chemotherapy. Non-curative treatment options include local tumour and metastasis treatments, and systemic anti-cancer therapy.
The aims of the thesis were to describe the patient characteristics, treatment and survival of curatively treated patients with MIBC and patients diagnosed upfront with metastatic bladder cancer (BC) before immunotherapy became part of BC treatment in 2018.
In this population-based study, we used data from the Cancer Registry of Norway and the National Patients Registry of patients diagnosed with BC in 2008-2016, and applied descriptive statistics and survival models.
This thesis shows that almost 50% of non-metastatic MIBC patients did not undergo curatively intended treatment. In addition, more than 50% of primary metastatic BC patients did not receive any initial anti-cancer treatment. The five-year overall survival following curative treatment was approximately 50%, with no difference in survival between patient with primary and secondary MIBC (progressed from the less aggressive non-muscle invasive BC) nor between patients treated with or without neoadjuvant chemotherapy. Downstaging of the primary tumour was associated with improved survival, and neoadjuvant chemotherapy increased the probability of achieving downstaging. Approximately one third of patients with metastatic BC were treated with initial chemotherapy with a median survival of 10 months and were frequently hospitalised.
Overall, the proportion of patients undergoing curative and non-curative treatment and the corresponding survival outcomes are comparable to similar international reports. The results serve as a basis for future comparative studies of similar outcomes when studying treatments with new emerging therapeutic options.
Additional information
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