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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
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- Palou, J. (författare)
- Univ Barcelona, Dept Urol, Fundacio Puigvert, Barcelona, Spain
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- Pisano, F. (författare)
- Univ Barcelona, Dept Urol, Fundacio Puigvert, Barcelona, Spain;Osped Citta Salute & Sci Molinette, Dept Urol, Corso Bramante 88, I-10126 Turin, Italy
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- Sylvester, R. (författare)
- EORTC Headquarters, Dept Biostat, Brussels, Belgium
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- 2018-05-02
- 2018
- Engelska.
- Ingår i: World journal of urology. - : SPRINGER. - 0724-4983 .- 1433-8726. ; 36:10, s. 1621-1627
- Tidskriftsartikel (refereegranskat)
Abstract
Ämnesord
Stäng
- 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 5.2years, 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.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Urologi och njurmedicin (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Urology and Nephrology (hsv//eng)
Nyckelord
- Non-muscle invasive bladder cancer
- Re-transurethral resection of the bladder
- Recurrence
- Progression
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- Palou, J.
- Pisano, F.
- Sylvester, R.
- Joniau, S.
- Serretta, V.
- Larre, S.
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- van Rhijn, B.
- Witjes, A. J.
- Grotenhuis, A.
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- Bartoletti, R.
- Dalbagni, G.
- Shariat, S. F.
- Xylinas, E.
- Karnes, R. J.
- Gontero, P.
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