{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T09:57:23Z","timestamp":1789466243865,"version":"build-2803163510"},"reference-count":45,"publisher":"American Society of Clinical Oncology (ASCO)","issue":"9","content-domain":{"domain":["ascopubs.org"],"crossmark-restriction":true},"short-container-title":["JCO Oncol Pract"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:sec>\n                    <jats:title>PURPOSE<\/jats:title>\n                    <jats:p>For patients with bladder cancer (BCa) undergoing radical cystectomy (RC), National Cancer Institute\u2013designated (NCI-D) cancer centers are considered the gold standard treatment hospital. Underserved populations face disparities in access to NCI-D and receive care at safety net hospitals (SNHs). Variation in quality of care for the underserved at safety-nets remains understudied. We hypothesized that safety-nets with NCI-D partnerships (affiliated safety-nets) would have superior RC outcomes compared with unaffiliated safety-nets.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>We compared outcomes for BCa undergoing RC between affiliated and unaffiliated safety-nets using the Texas Cancer Registry. Federal payments to hospitals for uncompensated care were used to identify safety-nets. Multivariate accelerated failure time modeled the primary outcome of overall (OS); secondary outcomes of pelvic lymph node dissection (PLND) and neoadjuvant chemotherapy (NAC) were modeled with logistic regression.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>\n                      From 2004 to 2019, there were 1,927 cases of RC. Overall survival was no different at affiliated safety-nets and NCI-D (hazard ratio [HR], 0.99;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .96), and was worse at unaffiliated safety-nets compared with NCI-D (HR, 1.28;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .03). Unaffiliated safety-nets had lower odds of NAC (odds ratio [OR], 0.61;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .02) and PLND (OR, 0.48;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; .001) compared with NCI-D or affiliated safety-nets.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSION<\/jats:title>\n                    <jats:p>NCI-D affiliated safety-nets may represent a subset of high preforming safety net hospitals for BCa patients undergoing RC. Survival differences are partly explained by greater odds of NAC and PLND at affiliated safety-nets. More work is needed to understand the drivers of higher-quality care at NCI-D affiliated safety net hospitals to improve BCa care across all safety net hospitals.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1200\/op-25-00330","type":"journal-article","created":{"date-parts":[[2026,1,6]],"date-time":"2026-01-06T20:59:28Z","timestamp":1767733168000},"page":"1572-1582","update-policy":"https:\/\/doi.org\/10.1200\/crossmark","source":"Crossref","is-referenced-by-count":1,"title":["Identification of High-Performing Safety Net Hospitals for Radical Cystectomy: Implications for National Cancer Institute Cancer Center Partnership"],"prefix":"10.1200","volume":"22","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3462-376X","authenticated-orcid":true,"given":"Raj","family":"Bhanvadia","sequence":"first","affiliation":[{"name":"Department of Urology, UT Southwestern Medical Center, Dallas, TX"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3008-0262","authenticated-orcid":true,"given":"Emily","family":"Bochner","sequence":"additional","affiliation":[{"name":"Department of Urology, UT Southwestern Medical Center, Dallas, TX"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7392-4154","authenticated-orcid":true,"given":"Changchuan","family":"Jiang","sequence":"additional","affiliation":[{"name":"Division of Hematology and Oncology, Department of Internal Medicine, UT Southwestern Medical Center, Dallas, TX"},{"name":"Peter J. 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