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Risk factors for re...
Risk factors for residual disease at re-TUR in a large cohort of T1G3 patients.
- Artikel/kapitelEngelska2021
Förlag, utgivningsår, omfång ...
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Elsevier BV,2021
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printrdacarrier
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LIBRIS-ID:oai:DiVA.org:uu-460916
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https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-460916URI
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https://doi.org/10.1016/j.acuroe.2020.08.014DOI
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Språk:engelska
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Sammanfattning på:engelska
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Ämneskategori:ref swepub-contenttype
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Ämneskategori:art swepub-publicationtype
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INTRODUCTION AND OBJECTIVES: The goals of transurethral resection of a bladder tumor (TUR) are to completely resect the lesions and to make a correct diagnosis in order to adequately stage the patient. It is well known that the presence of detrusor muscle in the specimen is a prerequisite to minimize the risk of under staging. Persistent disease after resection of bladder tumors is not uncommon and is the reason why the European Guidelines recommended a re-TUR for all T1 tumors. It was recently published that when there is muscle in the specimen, re-TUR does not influence progression or cancer specific survival. We present here the patient and tumor factors that may influence the presence of residual disease at re-TUR.MATERIAL AND METHODS: In our retrospective cohort of 2451 primary T1G3 patients initially treated with BCG, pathology results for 934 patients (38.1%) who underwent re-TUR are available. 74% had multifocal tumors, 20% of tumors were more than 3 cm in diameter and 26% had concomitant CIS. In this subgroup of patients who underwent re-TUR, there was no residual disease in 267 patients (29%) and residual disease in 667 patients (71%): Ta in 378 (40%) and T1 in 289 (31%) patients. Age, gender, tumor status (primary/recurrent), previous intravesical therapy, tumor size, tumor multi-focality, presence of concomitant CIS, and muscle in the specimen were analyzed in order to evaluate risk factors of residual disease at re-TUR, both in univariate analyses and multivariate logistic regressions.RESULTS: The following were not risk factors for residual disease: age, gender, tumor status and previous intravesical chemotherapy. The following were univariate risk factors for presence of residual disease: no muscle in TUR, multiple tumors, tumors > 3 cm, and presence of concomitant CIS. Due to the correlation between tumor multi-focality and tumor size, the multivariate model retained either the number of tumors or the tumor diameter (but not both), p < 0.001. The presence of muscle in the specimen was no longer significant, while the presence of CIS only remained significant in the model with tumor size, p < 0.001.CONCLUSIONS: The most significant factors for a higher risk of residual disease at re-TUR in T1G3 patients are multifocal tumors and tumors more than 3 cm. Patients with concomitant CIS and those without muscle in the specimen also have a higher risk of residual disease.
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Biuppslag (personer, institutioner, konferenser, titlar ...)
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Gontero, P
(författare)
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Sylvester, R
(författare)
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Joniau, S
(författare)
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Serretta, V
(författare)
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Larré, S
(författare)
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Di Stasi, S
(författare)
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van Rhijn, B
(författare)
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Witjes, A
(författare)
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Grotenhuis, A
(författare)
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Colombo, R
(författare)
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Briganti, A
(författare)
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Babjuk, M
(författare)
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Soukup, V
(författare)
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Malmström, Per-UnoUppsala universitet,Urologkirurgi(Swepub:uu)perunoms
(författare)
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Irani, J
(författare)
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Malats, N
(författare)
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Baniel, J
(författare)
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Mano, R
(författare)
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Cai, T
(författare)
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Cha, E
(författare)
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Ardelt, P
(författare)
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Varkarakis, J
(författare)
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Bartoletti, R
(författare)
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Dalbagni, G
(författare)
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Shariat, S F
(författare)
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Xylinas, E
(författare)
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Karnes, R J
(författare)
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Palou, J
(författare)
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Uppsala universitetUrologkirurgi
(creator_code:org_t)
Sammanhörande titlar
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Ingår i:Actas urologicas espanolas: Elsevier BV45:6, s. 473-4782173-5786
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Till lärosätets databas
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Pisano, F
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Gontero, P
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Sylvester, R
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Joniau, S
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Serretta, V
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Larré, S
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visa fler...
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Di Stasi, S
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van Rhijn, B
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Witjes, A
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Grotenhuis, A
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Colombo, R
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Briganti, A
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Babjuk, M
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Soukup, V
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Malmström, Per-U ...
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Irani, J
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Malats, N
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Baniel, J
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Mano, R
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Cai, T
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Cha, E
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Ardelt, P
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Varkarakis, J
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Bartoletti, R
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Dalbagni, G
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Shariat, S F
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Xylinas, E
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Karnes, R J
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Palou, J
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