TY - JOUR
T1 - High-Grade T1 on Re-Transurethral Resection after Initial High-Grade T1 Confers Worse Oncological Outcomes:
T2 - Results of a Multi-Institutional Study
AU - Ferro, Matteo
AU - Vartolomei, Mihai Dorin
AU - Cantiello, Francesco
AU - Lucarelli, Giuseppe
AU - Di Stasi, Savino M.
AU - Hurle, Rodolfo
AU - Guazzoni, Giorgio
AU - Busetto, Gian Maria
AU - De Berardinis, Ettore
AU - Damiano, Rocco
AU - Perdonà, Sisto
AU - Borghesi, Marco
AU - Schiavina, Riccardo
AU - Almeida, Gilberto L.
AU - Bove, Pierluigi
AU - Lima, Estevao
AU - Grimaldi, Giovanni
AU - Autorino, Riccardo
AU - Crisan, Nicolae
AU - Abu Farhan, Abdal Rahman
AU - Verze, Paolo
AU - Battaglia, Michele
AU - Serretta, Vincenzo
AU - Russo, Giorgio Ivan
AU - Morgia, Giuseppe
AU - Musi, Gennaro
AU - de Cobelli, Ottavio
AU - Mirone, Vincenzo
AU - Shariat, Shahrokh F.
PY - 2018
Y1 - 2018
N2 - Introduction: The aim of this multicenter study was to investigate the prognostic impact of residual T1 high-grade (HG)/G3 tumors at re-transurethral resection (TUR of bladder tumor) in a large multi-institutional cohort of patients with primary T1 HG/G3 bladder cancer (BC). Patients and Methods: The study period was from January 2002 to December 2012. A total of 1,046 patients with primary T1 HG/G3 and who had non-muscle invasive BC (NMIBC) on re-TUR followed by adjuvant intravesical Bacillus Calmette-Guerin (BCG) therapy with maintenance were included. Endpoints were time to disease recurrence, progression, and overall and cancer-specific death. Results: A total of 257 (24.6%) patients had residual T1 HG/G3 tumors. The presence of concomitant carcinoma in situ, multiple and large tumors (> 3 cm) at first TUR were associated with residual T1 HG/G3. Five-year recurrence-free survival (RFS), progression-free survival (PFS), overall survival (OS), and cancer-specific survival (CSS) were 17% (CI 11.8–23); 58.2% (CI 50.7–65); 73.7% (CI 66.3–79.7); and 84.5% (CI 77.8–89.3), respectively, in patients with residual T1 HG/G3, compared to 36.7% (CI 32.8–40.6); 71.4% (CI 67.3–75.2); 89.8% (CI 86.6–92.3); and 95.7% (CI 93.4–97.3), respectively, in patients with NMIBC other than T1 HG/G3 or T0 tumors. Residual T1 HG/G3 was independently associated with RFS, PFS, OS, and CSS in multivariable analyses. Conclusions: Residual T1 HG/G3 tumor at re-TUR confers worse prognosis in patients with primary T1 HG/G3 treated with maintenance BCG. Patients with residual T1 HG/G3 for primary T1 HG/G3 are very likely to fail BCG therapy alone.
AB - Introduction: The aim of this multicenter study was to investigate the prognostic impact of residual T1 high-grade (HG)/G3 tumors at re-transurethral resection (TUR of bladder tumor) in a large multi-institutional cohort of patients with primary T1 HG/G3 bladder cancer (BC). Patients and Methods: The study period was from January 2002 to December 2012. A total of 1,046 patients with primary T1 HG/G3 and who had non-muscle invasive BC (NMIBC) on re-TUR followed by adjuvant intravesical Bacillus Calmette-Guerin (BCG) therapy with maintenance were included. Endpoints were time to disease recurrence, progression, and overall and cancer-specific death. Results: A total of 257 (24.6%) patients had residual T1 HG/G3 tumors. The presence of concomitant carcinoma in situ, multiple and large tumors (> 3 cm) at first TUR were associated with residual T1 HG/G3. Five-year recurrence-free survival (RFS), progression-free survival (PFS), overall survival (OS), and cancer-specific survival (CSS) were 17% (CI 11.8–23); 58.2% (CI 50.7–65); 73.7% (CI 66.3–79.7); and 84.5% (CI 77.8–89.3), respectively, in patients with residual T1 HG/G3, compared to 36.7% (CI 32.8–40.6); 71.4% (CI 67.3–75.2); 89.8% (CI 86.6–92.3); and 95.7% (CI 93.4–97.3), respectively, in patients with NMIBC other than T1 HG/G3 or T0 tumors. Residual T1 HG/G3 was independently associated with RFS, PFS, OS, and CSS in multivariable analyses. Conclusions: Residual T1 HG/G3 tumor at re-TUR confers worse prognosis in patients with primary T1 HG/G3 treated with maintenance BCG. Patients with residual T1 HG/G3 for primary T1 HG/G3 are very likely to fail BCG therapy alone.
KW - Bladder cancer
KW - High risk
KW - High-grade
KW - Second look resection
KW - Transurethral resection of bladder tumor
U2 - 10.1159/000490765
DO - 10.1159/000490765
M3 - Article
SP - 7
EP - 15
JO - Urologia Internationalis
JF - Urologia Internationalis
SN - 0042-1138
ER -