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| Urologia internationalis. 2018 Jul 4. pii: 000490765. doi: 10.1159/000490765 |
| High-Grade T1 on Re-Transurethral Resection after Initial High-Grade T1 Confers Worse Oncological Outcomes: Results of a Multi-Institutional Study. |
| Ferro M1, Vartolomei MD2, Cantiello F3, Lucarelli G4, Di Stasi SM5, Hurle R6, Guazzoni G7, Busetto GM8, De Berardinis E9, Damiano R10, Perdonà S11, Borghesi M12, Schiavina R13, Almeida GL14, Bove P15, Lima E16, Grimaldi G17, Autorino R18, Crisan N19, Abu Farhan AR20, Verze P21, Battaglia M22, Serretta V23, Russo GI24, Morgia G25, Musi G26, de Cobelli O27, Mirone V28, Shariat SF29 |
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Abstract INTRODUCTION: The aim of this multicenter study was to investigate the prognostic impact of residual T1 high-grade (HG)/G3 tumors at re-transurethral resection (TUR of bladder tumor) in a large multi-institutional cohort of patients with primary T1 HG/G3 bladder cancer (BC). PATIENTS AND METHODS: The study period was from January 2002 to -December 2012. A total of 1,046 patients with primary T1 HG/G3 and who had non-muscle invasive BC (NMIBC) on re-TUR followed by adjuvant intravesical Bacillus Calmette-Guerin (BCG) therapy with maintenance were included. Endpoints were time to disease recurrence, progression, and overall and cancer-specific death. RESULTS: A total of 257 (24.6%) patients had residual T1 HG/G3 tumors. The presence of concomitant carcinoma in situ, multiple and large tumors (> 3 cm) at first TUR were associated with residual T1 HG/G3. Five-year recurrence-free survival (RFS), progression-free survival (PFS), overall survival (OS), and cancer-specific survival (CSS) were 17% (CI 11.8-23); 58.2% (CI 50.7-65); 73.7% (CI 66.3-79.7); and 84.5% (CI 77.8-89.3), respectively, in patients with residual T1 HG/G3, compared to 36.7% (CI 32.8-40.6); 71.4% (CI 67.3-75.2); 89.8% (CI 86.6-92.3); and 95.7% (CI 93.4-97.3), respectively, in patients with NMIBC other than T1 HG/G3 or T0 tumors. Residual T1 HG/G3 was independently associated with RFS, PFS, OS, and CSS in multivariable analyses. CONCLUSIONS: Residual T1 HG/G3 tumor at re-TUR confers worse prognosis in patients with primary T1 HG/G3 treated with maintenance BCG. Patients with residual T1 HG/G3 for primary T1 HG/G3 are very likely to fail BCG therapy alone. |
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© 2018 S. Karger AG, Basel. |
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KEYWORDS: Bladder cancer, High risk, High-grade, Second look resection, Transurethral resection of bladder tumor |
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Publikations ID: 29975950 Quelle: öffnen |
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