Evidence map›Paper›PMID 40989073›Full record

ArticleBJUI compass2025

Waiting time in diagnosis and extirpative surgery and association with survival and stage progression in upper tract urothelial carcinomas.

Fredrik Liedberg, Oskar Hagberg, Christel Häggström, Firas Aljabery, Truls Gårdmark, Staffan Jahnson, Tomas Jerlström, Viveka Ströck, Karin Söderkvist, Anders Ullén and 2 more

Abstract read
In one paragraph

Article in BJUI compass, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed, 1 pooled it
–field-weighted citation impact
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

2 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
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

12 authors.

Fredrik LiedbergDepartment of Urology Skåne University Hospital Malmö Sweden.ORCID https://orcid.org/0000-0001-8193-0370
Oskar HagbergInstitution of Translational Medicine Lund University Malmö Sweden.
Christel HäggströmDepartment of Surgical Sciences Uppsala University Uppsala Sweden.ORCID https://orcid.org/0000-0001-6808-4405
Firas AljaberyDepartment of Clinical and Experimental Medicine, Division of Urology Linköping University Linköping Sweden.ORCID https://orcid.org/0000-0002-8072-3625
Truls GårdmarkDepartment of Clinical Sciences, Danderyd Hospital Karolinska Institute Stockholm Sweden.ORCID https://orcid.org/0000-0003-4610-0771
Staffan JahnsonDepartment of Clinical and Experimental Medicine, Division of Urology Linköping University Linköping Sweden.ORCID https://orcid.org/0000-0001-8012-2742
Tomas JerlströmDepartment of Urology, School of Medical Sciences, Faculty of Medicine and Health Örebro University Örebro Sweden.ORCID https://orcid.org/0000-0003-4615-5238
Viveka StröckDepartment of Urology, Sahlgrenska University Hospital and Institute of Clinical Sciences, Sahlgrenska Academy University of Gothenburg Sweden.ORCID https://orcid.org/0000-0003-2050-6466
Karin SöderkvistDepartment of Diagnostics and Intervention Umeå University Umeå Sweden.ORCID https://orcid.org/0000-0002-3683-3763
Anders UllénDepartment of Oncology-Pathology Karolinska Institutet Stockholm Sweden.
Lars HolmbergDepartment of Surgical Sciences Uppsala University Uppsala Sweden.ORCID https://orcid.org/0000-0003-4417-7396
Johannes BobjerDepartment of Urology Skåne University Hospital Malmö Sweden.ORCID https://orcid.org/0000-0001-8495-3498

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Objectives: To investigate the association between waiting time and outcomes in patients with upper tract urothelial carcinomas (UTUC). Patients and methods: We studied a population-based cohort of 858 patients in BladderBaSe 2.0 subjected to extirpative surgery for UTUC 2015-2019 in Sweden. Diagnostic waiting time (from referral to diagnosis, reference <1 week), treatment waiting time (from diagnosis to surgery, reference <5 weeks) and total waiting time (reference <10 weeks) were investigated in relation to disease-specific (DSS) and overall survival (OS) by multivariable Cox regression models. To further explore these associations, stage progression from preoperatively recorded clinical tumour stage to pathological tumour stage in the extirpated specimen was assessed by logistic regression. Results: Total waiting time was not associated with DSS, OS or stage progression. A diagnostic waiting time between 1 and 4 weeks was associated with better DSS (HR 0.57 [95% CI 0.35-0.94]) and OS (HR 0.60 [95% CI 0.41-0.87]). In the strata of patients with UTUC in the renal pelvis, a diagnostic waiting time > 4 weeks was associated with stage progression (OR 2.44 [95% CI 1.00-5.95]), and in patients with UTUC in the ureter, a treatment waiting time between 5 and 10 weeks was associated to worse DSS (HR 2.85 (95% CI 1.03-7.89). Conclusions: In general, shorter care pathways were linked to beneficial survival estimates, yet some estimates may be influenced by selection bias due to prioritizing short waiting times for patients with advanced and/or overt symptomatic tumours. Stage progression with increased waiting time may indicate an underlying causal mechanism.

Indexed as

diagnostic delayradical nephroureterectomysegmental ureterectomytotal delaytreatment delayupper tract urothelial carcinoma

Identifiers

PMID40989073
PMCPMC12453665

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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.