TY - JOUR
T1 - Impact of tumor size on the oncological outcome of high-grade nonmuscle invasive bladder cancer - examining the utility of classifying Ta bladder cancer based on size.
AU - Tully, Karl H.
AU - Moschini, Marco
AU - von Rundstedt, Friedrich-Carl E.
AU - Aziz, Atiqullah
AU - Kluth, Luis A.
AU - Necchi, Andrea
AU - Rink, Michael
AU - Hendricksen, Kees
AU - Sargos, Paul
AU - Vetterlein, Malte W.
AU - Seiler, Roland
AU - Poyet, Cedric
AU - Krajewski, Wojciech
AU - Fajkovic, Harun
AU - Shariat, Shahrokh F.
AU - Xylinas, Evanguelos
AU - Roghmann, Florian
N1 - Place: United States
PY - 2020/11/1
Y1 - 2020/11/1
N2 - PURPOSE: To examine survival rates and to calculate the risk of disease recurrence, progression, overall, and cancer-specific mortality in patients diagnosed with high-risk NMIBC using a multi-institutional dataset to evaluate differences between the guidelines of the European Association of Urology and the guidelines of the National Comprehensive Cancer Network (NCCN) with regard to tumor size in risk stratification. METHODS AND MATERIAL: In total 1,116 individuals diagnosed with high-risk NMIBC between 2001 and 2013 were included in the analysis. Patients were stratified to NCCN guideline recommendations (high-grade T1, high-grade Ta ≤ 3 cm, and high-grade Ta textgreater 3 cm). Recurrence and progression rates were calculated. Kaplan-Meier curves were fitted to examine differences in recurrence-free (RFS) and progression-free survival (PFS). Multivariable Cox proportional hazards regression models were employed to calculate differences in the RFS, PFS, overall, and cancer-specific survival (CSS). RESULTS: The majority of patients were diagnosed with high-grade T1 disease (N = 576, 51.6, while 34.24.2grade Ta ≤ 3 cm and Ta textgreater 3 cm NMIBC, respectively. The 1- and 5-year RFS (1-year: 80.54.9 5-year: 58.68.3 P = 0.048) and PFS (1-year: 99.18.6 5-year: 97.72.4 P = 0.054) rates were higher in patients with Ta ≤ 3 cm. Patients diagnosed with high-grade Ta textgreater 3 cm experienced unfavorable progression-free, and cancer-specific survival compared to high-grade Ta ≤ 3 cm, respectively (PFS: 2.41, 95CI] 1.05-5.56, P = 0.038; CSS: hazard ratios [HR] 2.22, 95.02-4.89, P = 0.048). CONCLUSION: Patients diagnosed with high-grade Ta NMIBC ≤3 cm demonstrated a favorable progression-free, and cancer-specific survival compared to patients diagnosed with high-grade Ta textgreater 3 cm and high-grade T1 NMIBC.
AB - PURPOSE: To examine survival rates and to calculate the risk of disease recurrence, progression, overall, and cancer-specific mortality in patients diagnosed with high-risk NMIBC using a multi-institutional dataset to evaluate differences between the guidelines of the European Association of Urology and the guidelines of the National Comprehensive Cancer Network (NCCN) with regard to tumor size in risk stratification. METHODS AND MATERIAL: In total 1,116 individuals diagnosed with high-risk NMIBC between 2001 and 2013 were included in the analysis. Patients were stratified to NCCN guideline recommendations (high-grade T1, high-grade Ta ≤ 3 cm, and high-grade Ta textgreater 3 cm). Recurrence and progression rates were calculated. Kaplan-Meier curves were fitted to examine differences in recurrence-free (RFS) and progression-free survival (PFS). Multivariable Cox proportional hazards regression models were employed to calculate differences in the RFS, PFS, overall, and cancer-specific survival (CSS). RESULTS: The majority of patients were diagnosed with high-grade T1 disease (N = 576, 51.6, while 34.24.2grade Ta ≤ 3 cm and Ta textgreater 3 cm NMIBC, respectively. The 1- and 5-year RFS (1-year: 80.54.9 5-year: 58.68.3 P = 0.048) and PFS (1-year: 99.18.6 5-year: 97.72.4 P = 0.054) rates were higher in patients with Ta ≤ 3 cm. Patients diagnosed with high-grade Ta textgreater 3 cm experienced unfavorable progression-free, and cancer-specific survival compared to high-grade Ta ≤ 3 cm, respectively (PFS: 2.41, 95CI] 1.05-5.56, P = 0.038; CSS: hazard ratios [HR] 2.22, 95.02-4.89, P = 0.048). CONCLUSION: Patients diagnosed with high-grade Ta NMIBC ≤3 cm demonstrated a favorable progression-free, and cancer-specific survival compared to patients diagnosed with high-grade Ta textgreater 3 cm and high-grade T1 NMIBC.
M3 - Article
JO - Urologic Oncology
JF - Urologic Oncology
SN - 1078-1439
IS - 11
ER -