Kebede Kassaw, Muluembet Worku
The contribution of productive safety net program for households food security and asset building in drought prone woredas of northeast Ethiopia
Heliyon
bladder cancer poses significant public health burden high recurrence progression rates patients nonmuscleinvasive bladder cancer nmibc current treatment options include bladdersparing therapies bst radical cystectomy associated risks benefits however evidence supporting optimal management decisions patients recurrent highgrade nmibc remains limited leading uncertainty patients clinicians cisto comparison intravesical therapy surgery treatment options study aims address critical knowledge gap comparing outcomes patients undergoing bst radical cystectomy cisto study pragmatic prospective observational cohort trial across 36 academic community urology practices us study enroll 572 patients diagnosis recurrent highgrade nmibc select management either bst radical cystectomy primary outcome healthrelated quality life qol 12 months measured eortcqlqc30 secondary outcomes include bladder cancerspecific qol progressionfree survival cancerspecific survival financial toxicity study also assess patient preferences treatment outcomes statistical analyses employ targeted maximum likelihood estimation tmle address treatment selection bias confounding indication cisto study powered detect clinically important differences qol cancerspecific survival two treatment approaches including diverse patient population study also aims assess outcomes across following patient characteristics age gender race burden comorbid health conditions cancer severity caregiver status social determinants health rurality treatment outcomes may also vary patient preferences health literacy baseline qol cisto study fill crucial evidence gap management recurrent highgrade nmibc providing evidencebased guidance patients clinicians choosing bst radical cystectomy cisto study provide evidencebased approach identifying right treatment right patient right time challenging clinical setting recurrent highgrade nmibc clinicaltrialsgov nct03933826 registered may 1 2019