6533b86cfe1ef96bd12c82a7

RESEARCH PRODUCT

Recurrence, progression and cancer-specific mortality according to stage at re-TUR in T1G3 bladder cancer patients treated with BCG: not as bad as previously thought

Juan PalouShahrokh F. ShariatRobert Jeffrey KarnesR. BartolettiNúria MalatsJack BanielJ. VarkarakisE.n. XylinasS. M. Di StasiEugene K. ChaPer-uno MalmströmJ. IraniT. Tony CaiGuido DalbagniS. JoniauPaolo GonteroViktor SoukupStéphane LarréAnne J. GrotenhuisAlfred WitjesMarek BabjukP. ArdeltRoy ManoAlberto BrigantiRichard SylvesterVincenzo SerrettaRenzo ColomboB.w.g. Van RhijnFrancesca Pisano

subject

NephrologyMalemedicine.medical_treatment030232 urology & nephrologyNon-muscle invasive bladder cancer · Re-transurethral resection of the bladder · Recurrence · ProgressionSettore MED/24 - Urologia0302 clinical medicineRetrospective StudieRe-transurethral resection of the bladderRecurrenceImmunologicCause of DeathCumulative incidenceStage (cooking)Cause of deathProgressionIntravesicalAdministration IntravesicalLocal030220 oncology & carcinogenesisAdministrationBCG VaccineDisease ProgressionFemaleNon-muscle invasive bladder cancerHumanReoperationmedicine.medical_specialtyUrologyUrologyCystectomyArticleFollow-Up StudieCystectomy03 medical and health sciencesAll institutes and research themes of the Radboud University Medical CenterAdjuvants ImmunologicInternal medicineUrological cancers Radboud Institute for Molecular Life Sciences [Radboudumc 15]medicineHumansAdjuvantsAgedNeoplasm StagingProportional Hazards ModelsRetrospective StudiesBladder cancerProportional hazards modelbusiness.industryNon-muscle invasive bladder cancer; Progression; Re-transurethral resection of the bladder; Recurrence; Adjuvants Immunologic; Administration Intravesical; Aged; BCG Vaccine; Cause of Death; Cystectomy; Disease Progression; Female; Follow-Up Studies; Humans; Male; Neoplasm Recurrence Local; Neoplasm Staging; Proportional Hazards Models; Reoperation; Retrospective Studies; Urinary Bladder NeoplasmsRetrospective cohort studymedicine.diseaseNeoplasm RecurrenceUrinary Bladder NeoplasmsProportional Hazards ModelNeoplasm Recurrence LocalbusinessFollow-Up Studies

description

PURPOSE: The goals of transurethral resection of a bladder tumor (TUR) are to completely resect the lesions and to make a correct diagnosis to adequately stage and treat the patient. Persistent disease after TUR is not uncommon and is why re-TUR is recommended in T1G3 patients. When there is T1 tumor in the re-TUR specimen, very high risks of progression (82%) have been reported. We analyze the risks of recurrence, progression to muscle-invasive disease and cancer-specific mortality (CSM) according to tumor stage at re-TUR in T1G3 patients treated with BCG. METHODS: In our retrospective cohort of 2451 T1G3 patients, 934 patients (38.1%) underwent re-TUR. 667 patients had residual disease (71.4%): Ta in 378 (40.5%), T1 in 289 (30.9%) patients. Times to recurrence, progression and CSM in the three groups were estimated using cumulative incidence functions and compared using the Cox regression model. RESULTS: During a median follow-up of 5.2 years, 512 patients recurred. The recurrence rate was significantly higher in patients with a T1 at re-TUR (P < 0.001). Progression rates differed according to the pathology at re-TUR, 25.3% in T1, 14.6% in Ta and 14.2% in case of no residual tumor (P < 0.001). Similar trends were seen in both patients with and without muscle in the original TUR specimen. CONCLUSIONS: Patients with T1G3 tumors and no residual disease or Ta at re-TUR have better recurrence, progression and CSM rates than previously reported, with a CSM rate of 13.1 and a 25.3% progression rate in re-TUR T1 disease. ispartof: WORLD JOURNAL OF UROLOGY vol:36 issue:10 pages:1621-1627 ispartof: location:Germany status: published

yearjournalcountryeditionlanguage
2018-05-02
10.1007/s00345-018-2299-2http://hdl.handle.net/2066/195867