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  • Gontero, Paolo (author)

Prognostic Factors and Risk Groups in T1G3 Non-Muscle-invasive Bladder Cancer Patients Initially Treated with Bacillus Calmette-Guerin : Results of a Retrospective Multicenter Study of 2451 Patients

  • Article/chapterEnglish2015

Publisher, publication year, extent ...

  • Elsevier BV,2015
  • printrdacarrier

Numbers

  • LIBRIS-ID:oai:DiVA.org:uu-240056
  • https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-240056URI
  • https://doi.org/10.1016/j.eururo.2014.06.040DOI
  • https://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-98424URI

Supplementary language notes

  • Language:English
  • Summary in:English

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  • Subject category:ref swepub-contenttype
  • Subject category:art swepub-publicationtype

Notes

  • Background: The impact of prognostic factors in T1G3 non-muscle-invasive bladder cancer (BCa) patients is critical for proper treatment decision making. Objective: To assess prognostic factors in patients who received bacillus Calmette Guerin (BCG) as initial intravesical treatment of T1G3 tumors and to identify a subgroup of high-risk patients who should be considered for more aggressive treatment. Design, setting, and participants: Individual patient data were collected for 2451 T1G3 patients from 23 centers who received BCG between 1990 and 2011. Outcome measurements and statistical analysis: Using Cox multivariable regression, the prognostic importance of several clinical variables was assessed for time to recurrence, progression, BCa-specific survival, and overall survival (OS). Results and limitations: With a median follow-up of 5.2 yr, 465 patients (19%) progressed, 509 (21%) underwent cystectomy, and 221 (9%) died because of BCa. In multivariable analyses, the most important prognostic factors for progression were age, tumor size, and concomitant carcinoma in situ (CIS); the most important prognostic factors for BCa-specific survival and OS were age and tumor size. Patients were divided into four risk groups for progression according to the number of adverse factors among age >= 70 yr, size >= 3 cm, and presence of CIS. Progression rates at 10 yr ranged from 17% to 52%. BCa-specific death rates at 10 yr were 32% in patients >= 70 yr with tumor size >= 3 cm and 13% otherwise. Conclusions: T1G3 patients >= 70 yr with tumors >= 3 cm and concomitant CIS should be treated more aggressively because of the high risk of progression. Patient summary: Although the majority of T1G3 patients can be safely treated with intravesical bacillus Calmette-Guerin, there is a subgroup of T1G3 patients with age >= 70 yr, tumor size >= 3 cm, and concomitant CIS who have a high risk of progression and thus require aggressive treatment.

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Added entries (persons, corporate bodies, meetings, titles ...)

  • Sylvester, Richard (author)
  • Pisano, Francesca (author)
  • Joniau, Steven (author)
  • Eeckt, Kathy Vander (author)
  • Serretta, Vincenzo (author)
  • Larre, Stephane (author)
  • Di Stasi, Savino (author)
  • Van Rhijn, Bas (author)
  • Witjes, Alfred J. (author)
  • Grotenhuis, Anne J. (author)
  • Kiemeney, Lambertus A. (author)
  • Colombo, Renzo (author)
  • Briganti, Alberto (author)
  • Babjuk, Marek (author)
  • Malmström, Per-UnoUppsala universitet,Urologkirurgi(Swepub:uu)perunoms (author)
  • Oderda, Marco (author)
  • Irani, Jacques (author)
  • Malats, Nuria (author)
  • Baniel, Jack (author)
  • Mano, Roy (author)
  • Cai, Tommaso (author)
  • Cha, Eugene K. (author)
  • Ardelt, Peter (author)
  • Varkarakis, John (author)
  • Bartoletti, Riccardo (author)
  • Spahn, Martin (author)
  • Johansson, RobertUmeå universitet,Onkologi(Swepub:umu)rojo0001 (author)
  • Frea, Bruno (author)
  • Soukup, Viktor (author)
  • Xylinas, Evanguelos (author)
  • Dalbagni, Guido (author)
  • Karnes, R. Jeffrey (author)
  • Shariat, Shahrokh F. (author)
  • Palou, Joan (author)
  • Uppsala universitetUrologkirurgi (creator_code:org_t)

Related titles

  • In:European Urology: Elsevier BV67:1, s. 74-820302-28381873-7560

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