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RESEARCH PRODUCT

Prognostic factors and risk groups in T1G3 non-muscle-invasive bladder cancer patients initially treated with Bacillus Calmette-Guérin: results of a retrospective multicenter study of 2451 patients.

Marco OderdaAnne J. GrotenhuisJoan PalouAlfred WitjesRoy ManoBas W.g. Van RhijnRobert JohanssonBruno FreaRichard SylvesterS. LarrèShahrokh F. ShariatP.-u. MalmströmKathy Vander EecktJ. VarkarakisViktor SoukupEvanguelos XylinasNúria MalatsLambertus A. KiemeneyAlberto BrigantiMartin SpahnEugene K. ChaRiccardo BartolettiSavino M. Di StasiJacques IraniT. Tony CaiR. Jeffrey KarnesSteven JoniauGuido DalbagniMarek BabjukPaolo GonteroJack BanielP. ArdeltVincenzo SerrettaRenzo ColomboFrancesca Pisano

subject

OncologyMaleNon–muscle-invasive bladderBacillus Calmette-Guerin; BCG; Non-muscle-invasive bladder cancer; Prognostic factors; T1G3Settore MED/24 - UrologiaRisk groupsRetrospective StudieRisk FactorsBCGAge Factorskin and connective tissue diseasesBacillus Calmette-GuerinBacillus (shape)Prognostic factorbiologyBacillus Calmette-Gue´rin BCG Non–muscle-invasive bladder cancer Prognostic factors T1G3Age FactorsBacillus Calmette-Gue´rinMiddle AgedPrognosisTumor BurdenBacilluSurvival RateUrological cancers Radboud Institute for Health Sciences [Radboudumc 15]Urinary Bladder NeoplasmBCG VaccineDisease ProgressionFemaleNon muscle invasiveCalmette-GuérinCarcinoma in SituHumanmedicine.medical_specialtyPrognosiNon-muscle-invasive bladder cancerUrologyUrologyT1G3Prognostic factorsCystectomyRisk AssessmentNon–muscle-invasive bladder cancerFollow-Up StudieAdjuvants ImmunologicInternal medicineUrological cancers Radboud Institute for Molecular Life Sciences [Radboudumc 15]medicinecancerHumansAgedRetrospective StudiesBladder cancerbusiness.industryRisk Factorbiology.organism_classificationmedicine.diseaseMulticenter studyUrinary Bladder NeoplasmsProper treatmentNeoplasm Recurrence LocalbusinessFollow-Up Studies

description

Contains fulltext : 153742.pdf (Publisher’s version ) (Closed access) BACKGROUND: The impact of prognostic factors in T1G3 non-muscle-invasive bladder cancer (BCa) patients is critical for proper treatment decision making. OBJECTIVE: To assess prognostic factors in patients who received bacillus Calmette-Guerin (BCG) as initial intravesical treatment of T1G3 tumors and to identify a subgroup of high-risk patients who should be considered for more aggressive treatment. DESIGN, SETTING, AND PARTICIPANTS: Individual patient data were collected for 2451 T1G3 patients from 23 centers who received BCG between 1990 and 2011. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: Using Cox multivariable regression, the prognostic importance of several clinical variables was assessed for time to recurrence, progression, BCa-specific survival, and overall survival (OS). RESULTS AND LIMITATIONS: With a median follow-up of 5.2 yr, 465 patients (19%) progressed, 509 (21%) underwent cystectomy, and 221 (9%) died because of BCa. In multivariable analyses, the most important prognostic factors for progression were age, tumor size, and concomitant carcinoma in situ (CIS); the most important prognostic factors for BCa-specific survival and OS were age and tumor size. Patients were divided into four risk groups for progression according to the number of adverse factors among age >/= 70 yr, size >/= 3 cm, and presence of CIS. Progression rates at 10 yr ranged from 17% to 52%. BCa-specific death rates at 10 yr were 32% in patients >/= 70 yr with tumor size >/= 3 cm and 13% otherwise. CONCLUSIONS: T1G3 patients >/= 70 yr with tumors >/= 3 cm and concomitant CIS should be treated more aggressively because of the high risk of progression. PATIENT SUMMARY: Although the majority of T1G3 patients can be safely treated with intravesical bacillus Calmette-Guerin, there is a subgroup of T1G3 patients with age >/= 70 yr, tumor size >/= 3 cm, and concomitant CIS who have a high risk of progression and thus require aggressive treatment.

yearjournalcountryeditionlanguage
2014-03-03European urology
10.1016/j.eururo.2014.06.040https://pubmed.ncbi.nlm.nih.gov/27186727