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Risk factors for re...
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Pisano, F.Univ Studies Turin, Citta Salute & Sci Torino, Turin, Italy.;Univ Barcelona, Dept Urol, Fundacio Puigvert, Barcelona, Spain.
(author)
Risk factors for residual disease at re-TUR in a large cohort of T1G3 patients
- Article/chapterEnglish2021
Publisher, publication year, extent ...
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ENE EDICIONES SL,2021
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printrdacarrier
Numbers
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LIBRIS-ID:oai:DiVA.org:uu-453572
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https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-453572URI
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https://doi.org/10.1016/j.acuro.2020.08.016DOI
Supplementary language notes
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Language:English
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Summary in:English
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Subject category:ref swepub-contenttype
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Subject category: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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Gontero, P.Univ Studies Turin, Citta Salute & Sci Torino, Turin, Italy.
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Sylvester, R.EORTC Headquarters, Dept Biostat, Brussels, Belgium.
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Joniau, S.Univ Hosp Leuven, Dept Urol, Oncol & Reconstruct Urol, Leuven, Belgium.
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Serretta, VUniv Palermo, Dept Surg Oncol & Stomatol Sci, Palermo, Italy.
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Larre, S.Univ Oxford, John Radcliffe Hosp, Dept Surg Sci, Oxford, England.
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Di Stasi, S.Policlin Tor Vergata Univ Rome, Rome, Italy.
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van Rhijn, B.Antoni van Leeuwenhoek Hosp, Netherlands Canc Inst, Dept Urol, Amsterdam, Netherlands.
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Witjes, A.Radboud Univ Nijmegen, Dept Urol, Med Ctr, Nijmegen, Netherlands.
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Grotenhuis, A.Radboud Univ Nijmegen, Dept Urol, Med Ctr, Nijmegen, Netherlands.
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Colombo, R.Univ Vita Salute, Dipartimento Urol, Osped S Raffaele, Milan, Italy.
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Briganti, A.Univ Vita Salute, Dipartimento Urol, Osped S Raffaele, Milan, Italy.
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Babjuk, M.Univ Praha, Motol Hosp, Dept Urol, Prague, Czech Republic.
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Soukup, VUniv Praha, Motol Hosp, Dept Urol, Prague, Czech Republic.
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Malmström, Per-UnoUppsala universitet,Urologkirurgi(Swepub:uu)perunoms
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Irani, J.Hosp Bicetre, Dept Urol, Le Kremlin Bicetre, France.
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Malats, N.Spanish Natl Canc Res Ctr CNIO, Genet & Mol Epidemiol Grp, Madrid, Spain.
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Baniel, J.Rabin Med Ctr, Dept Urol, Tel Aviv, Israel.
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Mano, R.Rabin Med Ctr, Dept Urol, Tel Aviv, Israel.
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Cai, T.Santa Chiara Hosp, Dept Urol, Trento, Italy.
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Cha, E.Mem Sloan Kettering Canc Ctr, Dept Urol, 1275 York Ave, New York, NY 10021 USA.
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Ardelt, P.Univ Hosp Basel, Urol Univ Clin Basel Liestal, Basel, Switzerland.
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Varkarakis, J.Univ Athens, Sismanoglio Hosp, Dept Urol, Athens, Greece.
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Bartoletti, R.Univ Florence, Dept Expt & Clin Med, Florence, Italy.
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Dalbagni, G.Mem Sloan Kettering Canc Ctr, Dept Urol, 1275 York Ave, New York, NY 10021 USA.
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Shariat, S. F.Med Univ Vienna, Dept Urol, A-1190 Vienna, Austria.;Cochin Hosp, Dept Urol, Paris, France.
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Xylinas, E.Mayo Clin, Dept Urol, Rochester, MN USA.
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Karnes, R. J.Mayo Clin, Dept Urol, Rochester, MN USA.
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Palou, J.Univ Barcelona, Dept Urol, Fundacio Puigvert, Barcelona, Spain.
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Univ Studies Turin, Citta Salute & Sci Torino, Turin, Italy.;Univ Barcelona, Dept Urol, Fundacio Puigvert, Barcelona, Spain.Univ Studies Turin, Citta Salute & Sci Torino, Turin, Italy.
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In:Actas Urológicas Españolas: ENE EDICIONES SL45:6, s. 473-4780210-48061699-7980
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- By the author/editor
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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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Larre, S.
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show more...
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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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