6533b85efe1ef96bd12bfd4f
RESEARCH PRODUCT
The impact of re-transurethral resection on clinical outcomes in a large multicentre cohort of patients with T1 high-grade/Grade 3 bladder cancer treated with bacille Calmette-Guerin
Alberto BrigantiRobert Jeffrey KarnesRoy ManoP. ArdeltS. LarrèRiccardo BartolettiJoan PalouJacques IraniNúria MalatsAlfred WitjesRichard SylvesterGuido DalbagniSavino M. Di StasiSteven JoniauAnne J. GrotenhuisVincenzo SerrettaRenzo ColomboMarek BabjukEugene K. ChaMarco OderdaBas W.g. Van RhijnEvanguelos XylinasPaolo GonteroViktor SoukupJack BanielShahrokh F. ShariatP.-u. MalmströmJohn VakarakisT. Tony CaiFrancesca Pisanosubject
Malemedicine.medical_treatment030232 urology & nephrologySettore MED/24 - Urologia0302 clinical medicineImmunologicRetrospective Studiehigh gradere-TURHazard ratioMiddle Agedmedicine.anatomical_structureAdministration IntravesicalTreatment Outcome030220 oncology & carcinogenesisUrological cancers Radboud Institute for Health Sciences [Radboudumc 15]CohortUrinary Bladder NeoplasmBCG VaccineUrologic Surgical Proceduresbladder cancerFemaleHumanReoperationmedicine.medical_specialtyrecurrenceUrologyUrologyT1G3CystectomyArticleCystectomy03 medical and health sciencesbladder cancer; high grade; progression; re-TUR; recurrence; T1G3; UrologyAdjuvants ImmunologicUrethramedicineHumansAdjuvantsT1G3; bladder cancer; high grade; progression; re-TUR; recurrenceRetrospective StudiesAgedNeoplasm StagingBladder cancerbusiness.industryCancerRetrospective cohort studymedicine.diseaseSurgerybladder cancer; high grade; progression; re-TUR; recurrence; T1G3; Adjuvants Immunologic; Aged; BCG Vaccine; Cystectomy; Female; Humans; Male; Middle Aged; Neoplasm Grading; Neoplasm Staging; Reoperation; Retrospective Studies; Treatment Outcome; Urethra; Urinary Bladder Neoplasms; UrologyUrethraUrinary Bladder NeoplasmsprogressionNeoplasm GradingbusinessBCG vaccinedescription
Objectives To determine if a re-transurethral resection (TUR), in the presence or absence of muscle at the first TUR in patients with T1-high grade (HG)/Grade 3 (G3) bladder cancer, makes a difference in recurrence, progression, cancer specific (CSS) and overall survival (OS). Patients and methods In a large retrospective multicentre cohort of 2451 patients with T1-HG/G3 initially treated with bacille Calmette–Gu erin, 935 (38%) had a re-TUR. According to the presence or absence of muscle in the specimen of the primary TUR, patients were divided in four groups: group 1 (no muscle, no re-TUR), group 2 (no muscle, re-TUR), group 3 (muscle, no re-TUR) and group 4 (muscle, re-TUR). Clinical outcomes were compared across the four groups. BJU Int 2016; 118: 44–52 wileyonlinelibrary.com Results Re-TUR had a positive impact on recurrence, progression, CSS and OS only if muscle was not present in the primary TUR specimen. Adjusting for the most important prognostic factors, re-TUR in the absence of muscle had a borderline significant effect on time to recurrence [hazard ratio (HR) 0.67, P = 0.08], progression (HR 0.46, P = 0.06), CSS (HR 0.31, P = 0.07) and OS (HR 0.48, P = 0.05). Re-TUR in the presence of muscle in the primary TUR specimen did not improve the outcome for any of the endpoints. Conclusions Our retrospective analysis suggests that re-TUR may not be necessary in patients with T1-HG/G3, if muscle is present in the specimen of the primary TUR.
| year | journal | country | edition | language |
|---|---|---|---|---|
| 2015-11-06 |