Evidence map›Paper›PMID 32869516›Full record

ArticleCancer medicine2020

Race modifies survival benefit of guideline-based treatment: Implications for reducing disparities in muscle invasive bladder cancer.

Samuel L Washington, Steven E Gregorich, Maxwell V Meng, Anne M Suskind, Sima P Porten

Open access · goldAbstract readComparative Study
In one paragraph

Article in Cancer medicine, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
1.6field-weighted citation impact, top 16% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 10 citations in OpenAlex.

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  6. Cancer treatment and survivorship statistics, 2025.CA: a cancer journal for clinicians
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors at 1 institution in 1 country.

Samuel L WashingtonDepartment of Urology, University of California, San Francisco, CA, USA.ORCID 0000-0002-2467-6115
Steven E GregorichSchool of Medicine, University of California, San Francisco, CA, USA.
Maxwell V MengDepartment of Urology, University of California, San Francisco, CA, USA.
Anne M SuskindDepartment of Urology, University of California, San Francisco, CA, USA.
Sima P PortenDepartment of Urology, University of California, San Francisco, CA, USA.ORCID 0000-0002-3948-4968
University of California, San Francisco · US

Funding

RESOURCE CENTER FOR AGING RESEARCH IN DIVERSE POPULATIONP30AG015272 · NIA · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI Nynikka Palmer · 1997 to 2026
$19.5M
NIA NIH HHS P30 AG015272
6 · The paper itself

Abstract

backgroundBlack individuals with muscle-invasive bladder cancer (MIBC) experienced 21% lower odds of guideline-based treatment (GBT) and differences in treatment explain 35% of observed Black-White differences in survival. Yet little is known of how interactions between race/ethnicity and receipt of GBT drive within- and between-race survival differences.

methodsBlack, White, and Latino individuals diagnosed with nonmetastatic, locally advanced MIBC from 2004 to 2013 within the National Cancer Database were included. Guideline-based treatment was defined as the receipt including one or more of the following treatment modalities: radical cystectomy (RC), neoadjuvant chemotherapy with RC, RC with adjuvant chemotherapy, and/or chemoradiation based on American Urological Association guidelines. Cox proportional hazards model of mortality estimated effects of GBT status, race/ethnicity, and the GBT-by-race/ethnicity interaction, adjusting for covariates.

resultsOf the 54 910 MIBC individuals with 125 821 person-years of posttreatment observation (max = 11 years), 6.9% were Black, and 3.0% were Latino. Overall, 51.4%, 45.3%, and 48.5% of White, Black, and Latino individuals received GBT. Latino individuals had lower hazard of death compared to Black (HR 0.81, 95% CI 0.75-0.87) and White individuals (HR 0.92, 95% 0.86-0.98). With GBT, Latino and White individuals had similar outcomes (HR = 1.00, 95% 0.91-1.10) and both fared better than Black individuals (HR = 0.88, 95% 0.79-0.99 and HR = 0.88, 95% 0.83-0.94, respectively). Without GBT, Latino individuals fared better than White (HR = 0.85, 95% 0.77-0.93) and Black individuals (HR = 0.74, 95% 0.67-0.82) while White individuals fared better than Black individuals (HR = 0.87, 95% 0.83-0.92). Black individuals with GBT fared worse than Latinos without GBT (HR = 1.02, 95% 0.92-1.14), although not statistically significant.

conclusionLow GBT levels demonstrated an "under-allocation" of GBT to those who needed it most-Black individuals. Interventions to improve GBT allocation may mitigate race-based survival differences observed in MIBC.

Indexed as

Black or African AmericanCystectomyHispanic or LatinoNeoadjuvant TherapyWhite PeopleAgedAged, 80 and overChemoradiotherapy, AdjuvantChemotherapy, AdjuvantDatabases, FactualFemaleHealthcare DisparitiesHumansMaleMiddle AgedRace FactorsAfrican continental ancestry groupcohort studiessocial determinants of healthUnited Statesurinary bladder neoplasms

Identifiers

PMID32869516
PMCPMC7666728
OpenAlexW3082322109

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.