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FältnamnIndikatorerMetadata
00006762naa a2200673 4500
001oai:DiVA.org:uu-453572
003SwePub
008210922s2021 | |||||||||||000 ||eng|
024a https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-4535722 URI
024a https://doi.org/10.1016/j.acuro.2020.08.0162 DOI
040 a (SwePub)uu
041 a engb eng
042 9 SwePub
072 7a ref2 swepub-contenttype
072 7a art2 swepub-publicationtype
100a Pisano, F.u Univ Studies Turin, Citta Salute & Sci Torino, Turin, Italy.;Univ Barcelona, Dept Urol, Fundacio Puigvert, Barcelona, Spain.4 aut
2451 0a Risk factors for residual disease at re-TUR in a large cohort of T1G3 patients
264 1b ENE EDICIONES SL,c 2021
338 a print2 rdacarrier
520 a 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.
650 7a MEDICIN OCH HÄLSOVETENSKAPx Klinisk medicinx Urologi och njurmedicin0 (SwePub)302142 hsv//swe
650 7a MEDICAL AND HEALTH SCIENCESx Clinical Medicinex Urology and Nephrology0 (SwePub)302142 hsv//eng
653 a Non-muscle invasive bladder cancer
653 a Re-transurethral resection of the bladder
653 a Residual disease
653 a Recurrence
653 a Progression
700a Gontero, P.u Univ Studies Turin, Citta Salute & Sci Torino, Turin, Italy.4 aut
700a Sylvester, R.u EORTC Headquarters, Dept Biostat, Brussels, Belgium.4 aut
700a Joniau, S.u Univ Hosp Leuven, Dept Urol, Oncol & Reconstruct Urol, Leuven, Belgium.4 aut
700a Serretta, Vu Univ Palermo, Dept Surg Oncol & Stomatol Sci, Palermo, Italy.4 aut
700a Larre, S.u Univ Oxford, John Radcliffe Hosp, Dept Surg Sci, Oxford, England.4 aut
700a Di Stasi, S.u Policlin Tor Vergata Univ Rome, Rome, Italy.4 aut
700a van Rhijn, B.u Antoni van Leeuwenhoek Hosp, Netherlands Canc Inst, Dept Urol, Amsterdam, Netherlands.4 aut
700a Witjes, A.u Radboud Univ Nijmegen, Dept Urol, Med Ctr, Nijmegen, Netherlands.4 aut
700a Grotenhuis, A.u Radboud Univ Nijmegen, Dept Urol, Med Ctr, Nijmegen, Netherlands.4 aut
700a Colombo, R.u Univ Vita Salute, Dipartimento Urol, Osped S Raffaele, Milan, Italy.4 aut
700a Briganti, A.u Univ Vita Salute, Dipartimento Urol, Osped S Raffaele, Milan, Italy.4 aut
700a Babjuk, M.u Univ Praha, Motol Hosp, Dept Urol, Prague, Czech Republic.4 aut
700a Soukup, Vu Univ Praha, Motol Hosp, Dept Urol, Prague, Czech Republic.4 aut
700a Malmström, Per-Unou Uppsala universitet,Urologkirurgi4 aut0 (Swepub:uu)perunoms
700a Irani, J.u Hosp Bicetre, Dept Urol, Le Kremlin Bicetre, France.4 aut
700a Malats, N.u Spanish Natl Canc Res Ctr CNIO, Genet & Mol Epidemiol Grp, Madrid, Spain.4 aut
700a Baniel, J.u Rabin Med Ctr, Dept Urol, Tel Aviv, Israel.4 aut
700a Mano, R.u Rabin Med Ctr, Dept Urol, Tel Aviv, Israel.4 aut
700a Cai, T.u Santa Chiara Hosp, Dept Urol, Trento, Italy.4 aut
700a Cha, E.u Mem Sloan Kettering Canc Ctr, Dept Urol, 1275 York Ave, New York, NY 10021 USA.4 aut
700a Ardelt, P.u Univ Hosp Basel, Urol Univ Clin Basel Liestal, Basel, Switzerland.4 aut
700a Varkarakis, J.u Univ Athens, Sismanoglio Hosp, Dept Urol, Athens, Greece.4 aut
700a Bartoletti, R.u Univ Florence, Dept Expt & Clin Med, Florence, Italy.4 aut
700a Dalbagni, G.u Mem Sloan Kettering Canc Ctr, Dept Urol, 1275 York Ave, New York, NY 10021 USA.4 aut
700a Shariat, S. F.u Med Univ Vienna, Dept Urol, A-1190 Vienna, Austria.;Cochin Hosp, Dept Urol, Paris, France.4 aut
700a Xylinas, E.u Mayo Clin, Dept Urol, Rochester, MN USA.4 aut
700a Karnes, R. J.u Mayo Clin, Dept Urol, Rochester, MN USA.4 aut
700a Palou, J.u Univ Barcelona, Dept Urol, Fundacio Puigvert, Barcelona, Spain.4 aut
710a Univ Studies Turin, Citta Salute & Sci Torino, Turin, Italy.;Univ Barcelona, Dept Urol, Fundacio Puigvert, Barcelona, Spain.b Univ Studies Turin, Citta Salute & Sci Torino, Turin, Italy.4 org
773t Actas Urológicas Españolasd : ENE EDICIONES SLg 45:6, s. 473-478q 45:6<473-478x 0210-4806x 1699-7980
8564 8u https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-453572
8564 8u https://doi.org/10.1016/j.acuro.2020.08.016

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