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

Vincenzo Serretta, Stéphane Larré, Anne J. Grotenhuis, Evanguelos Xylinas, Alfred J. Witjes, Roy Mano, Palou, Eugene K. Cha, Tommaso Cai, Bas Van Rhijn, Steven Joniau, R. Jeffrey Karnes, Peter Ardelt, Marek Babjuk, John Varkarakis, Paolo Gontero, Nuria Malats, Guido Dalbagni, Per-Uno Malmstrom, Shahrokh F. ShariatSavino Di Stasi, Riccardo Bartoletti, Francesca Pisano, Joan Palou, Jacques Irani, Jack Baniel, Renzo Colombo, Richard Sylvester, Tommaso Cai, Viktor Soukup, Alberto Briganti, Annunziata Briganti, Maria Francesca Pisano

Risultato della ricerca: Articlepeer review

14 Citazioni (Scopus)

Abstract

PurposeThe 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.MethodsIn 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.ResultsDuring 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.ConclusionsPatients 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.
Lingua originaleEnglish
pagine (da-a)1621-1627
Numero di pagine8
RivistaWorld Journal of Urology
Volume36
Stato di pubblicazionePublished - 2018

All Science Journal Classification (ASJC) codes

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