Patterns of care and associated social determinants of health in the definitive treatment of localized muscle-invasive bladder cancer patients

Background: Neoadjuvant chemotherapy followed by radical cystectomy (NACT-RC) is the prevailing standard of care for muscle-invasive bladder cancer (MIBC), but trimodality treatment (TMT) using chemoradiation after transurethral resection of bladder tumor (TURBT) is an effective alternative in select patients. Objective: This study examined patterns of care and impact of social determinants of health on the overall survival (OS) using the National Cancer Database (NCDB). Methods: Data on patients aged ≥18 years with stage II-IIIA MIBC treated with TMT or NACT-RC during 2014-2021 were analyzed with propensity score matching. Logistic and Cox regression were used to evaluate the association of social determinants of health with patterns of care and OS. Results: =0.001). Conclusion: TMT for MIBC has increased in recent years. Selection between NACT-RC and TMT was influenced by age, stage, diagnosis year, comorbidities, travel distance, facility, and insurance type, highlighting disparities in MIBC treatment. Categories: Radiation Oncology, Oncology.