Predictors of oncological outcomes in T1G3 patients treated with BCG who undergo radical cystectomy

F Soria, F Pisano, P Gontero, J Palou, S Joniau, V Serretta, S Larré, S Di Stasi, B van Rhijn, JA Witjes, A Grotenhuis, R Colombo, A Briganti, M Babjuk, V Soukup, PU Malmstrom, J Irani, N Malats, J Baniel, R ManoT Cai, E Cha, P Ardelt, J Varkarakis, R Bartoletti, G Dalbagni, SF Shariat, E Xylinas, RJ Karnes, R Sylvester

Research output: Contribution to journalArticle

Abstract

Purpose: To evaluate the oncological impact of postponing radical cystectomy (RC) to allow further conservative therapies prior to progression in a large multicentre retrospective cohort of T1-HG/G3 patients initially treated with BCG. Methods: According to the time of RC, the population was divided into 3 groups: patients who did not progress to muscle-invasive disease, patients who progressed before radical cystectomy and patients who experienced progression at the time of radical cystectomy. Clinical and pathological outcomes were compared across the three groups. Results: Of 2451 patients, 509 (20.8%) underwent RC. Patients with tumors > 3 cm or with CIS had earlier cystectomies (HR = 1.79, p = 0.001 and HR = 1.53, p = 0.02, respectively). Patients with tumors > 3 cm, multiple tumors or CIS had earlier T3/T4 or N + cystectomies. In patients who progressed, the timing of cystectomy did not affect the risk of T3/T4 or N + disease at RC. Patients with T3/T4 or N + disease at RC had a shorter disease-specific survival (HR = 4.38, p <0.001), as did patients with CIS at cystectomy (HR = 2.39, p <0.001). Patients who progressed prior to cystectomy had a shorter disease-specific survival than patients for whom progression was only detected at cystectomy (HR = 0.58, p = 0.024) Conclusions: Patients treated with RC before experiencing progression to muscle-invasive disease harbor better oncological and survival outcomes compared to those who progressed before RC and to those upstaged at surgery. Tumor size and concomitant CIS at diagnosis are the main predictors of surgical treatment while tumor size, CIS and tumor multiplicity are associated with extravesical disease at surgery. © 2018, Springer-Verlag GmbH Germany, part of Springer Nature.
Original languageEnglish
Pages (from-to)1775-1781
Number of pages7
JournalWorld Journal of Urology
Volume36
Issue number11
DOIs
Publication statusPublished - 2018

Fingerprint

Cystectomy
Mycobacterium bovis
Neoplasms
Survival
Muscles
Germany

Cite this

Soria, F., Pisano, F., Gontero, P., Palou, J., Joniau, S., Serretta, V., ... Sylvester, R. (2018). Predictors of oncological outcomes in T1G3 patients treated with BCG who undergo radical cystectomy. World Journal of Urology, 36(11), 1775-1781. https://doi.org/10.1007/s00345-018-2450-0

Predictors of oncological outcomes in T1G3 patients treated with BCG who undergo radical cystectomy. / Soria, F; Pisano, F; Gontero, P; Palou, J; Joniau, S; Serretta, V; Larré, S; Di Stasi, S; van Rhijn, B; Witjes, JA; Grotenhuis, A; Colombo, R; Briganti, A; Babjuk, M; Soukup, V; Malmstrom, PU; Irani, J; Malats, N; Baniel, J; Mano, R; Cai, T; Cha, E; Ardelt, P; Varkarakis, J; Bartoletti, R; Dalbagni, G; Shariat, SF; Xylinas, E; Karnes, RJ; Sylvester, R.

In: World Journal of Urology, Vol. 36, No. 11, 2018, p. 1775-1781.

Research output: Contribution to journalArticle

Soria, F, Pisano, F, Gontero, P, Palou, J, Joniau, S, Serretta, V, Larré, S, Di Stasi, S, van Rhijn, B, Witjes, JA, Grotenhuis, A, Colombo, R, Briganti, A, Babjuk, M, Soukup, V, Malmstrom, PU, Irani, J, Malats, N, Baniel, J, Mano, R, Cai, T, Cha, E, Ardelt, P, Varkarakis, J, Bartoletti, R, Dalbagni, G, Shariat, SF, Xylinas, E, Karnes, RJ & Sylvester, R 2018, 'Predictors of oncological outcomes in T1G3 patients treated with BCG who undergo radical cystectomy', World Journal of Urology, vol. 36, no. 11, pp. 1775-1781. https://doi.org/10.1007/s00345-018-2450-0
Soria, F ; Pisano, F ; Gontero, P ; Palou, J ; Joniau, S ; Serretta, V ; Larré, S ; Di Stasi, S ; van Rhijn, B ; Witjes, JA ; Grotenhuis, A ; Colombo, R ; Briganti, A ; Babjuk, M ; Soukup, V ; Malmstrom, PU ; Irani, J ; Malats, N ; Baniel, J ; Mano, R ; Cai, T ; Cha, E ; Ardelt, P ; Varkarakis, J ; Bartoletti, R ; Dalbagni, G ; Shariat, SF ; Xylinas, E ; Karnes, RJ ; Sylvester, R. / Predictors of oncological outcomes in T1G3 patients treated with BCG who undergo radical cystectomy. In: World Journal of Urology. 2018 ; Vol. 36, No. 11. pp. 1775-1781.
@article{a46a0daefb394f149ed9d34cf299154a,
title = "Predictors of oncological outcomes in T1G3 patients treated with BCG who undergo radical cystectomy",
abstract = "Purpose: To evaluate the oncological impact of postponing radical cystectomy (RC) to allow further conservative therapies prior to progression in a large multicentre retrospective cohort of T1-HG/G3 patients initially treated with BCG. Methods: According to the time of RC, the population was divided into 3 groups: patients who did not progress to muscle-invasive disease, patients who progressed before radical cystectomy and patients who experienced progression at the time of radical cystectomy. Clinical and pathological outcomes were compared across the three groups. Results: Of 2451 patients, 509 (20.8{\%}) underwent RC. Patients with tumors > 3 cm or with CIS had earlier cystectomies (HR = 1.79, p = 0.001 and HR = 1.53, p = 0.02, respectively). Patients with tumors > 3 cm, multiple tumors or CIS had earlier T3/T4 or N + cystectomies. In patients who progressed, the timing of cystectomy did not affect the risk of T3/T4 or N + disease at RC. Patients with T3/T4 or N + disease at RC had a shorter disease-specific survival (HR = 4.38, p <0.001), as did patients with CIS at cystectomy (HR = 2.39, p <0.001). Patients who progressed prior to cystectomy had a shorter disease-specific survival than patients for whom progression was only detected at cystectomy (HR = 0.58, p = 0.024) Conclusions: Patients treated with RC before experiencing progression to muscle-invasive disease harbor better oncological and survival outcomes compared to those who progressed before RC and to those upstaged at surgery. Tumor size and concomitant CIS at diagnosis are the main predictors of surgical treatment while tumor size, CIS and tumor multiplicity are associated with extravesical disease at surgery. {\circledC} 2018, Springer-Verlag GmbH Germany, part of Springer Nature.",
author = "F Soria and F Pisano and P Gontero and J Palou and S Joniau and V Serretta and S Larr{\'e} and {Di Stasi}, S and {van Rhijn}, B and JA Witjes and A Grotenhuis and R Colombo and A Briganti and M Babjuk and V Soukup and PU Malmstrom and J Irani and N Malats and J Baniel and R Mano and T Cai and E Cha and P Ardelt and J Varkarakis and R Bartoletti and G Dalbagni and SF Shariat and E Xylinas and RJ Karnes and R Sylvester",
year = "2018",
doi = "10.1007/s00345-018-2450-0",
language = "English",
volume = "36",
pages = "1775--1781",
journal = "World Journal of Urology",
issn = "0724-4983",
publisher = "Springer Verlag",
number = "11",

}

TY - JOUR

T1 - Predictors of oncological outcomes in T1G3 patients treated with BCG who undergo radical cystectomy

AU - Soria, F

AU - Pisano, F

AU - Gontero, P

AU - Palou, J

AU - Joniau, S

AU - Serretta, V

AU - Larré, S

AU - Di Stasi, S

AU - van Rhijn, B

AU - Witjes, JA

AU - Grotenhuis, A

AU - Colombo, R

AU - Briganti, A

AU - Babjuk, M

AU - Soukup, V

AU - Malmstrom, PU

AU - Irani, J

AU - Malats, N

AU - Baniel, J

AU - Mano, R

AU - Cai, T

AU - Cha, E

AU - Ardelt, P

AU - Varkarakis, J

AU - Bartoletti, R

AU - Dalbagni, G

AU - Shariat, SF

AU - Xylinas, E

AU - Karnes, RJ

AU - Sylvester, R

PY - 2018

Y1 - 2018

N2 - Purpose: To evaluate the oncological impact of postponing radical cystectomy (RC) to allow further conservative therapies prior to progression in a large multicentre retrospective cohort of T1-HG/G3 patients initially treated with BCG. Methods: According to the time of RC, the population was divided into 3 groups: patients who did not progress to muscle-invasive disease, patients who progressed before radical cystectomy and patients who experienced progression at the time of radical cystectomy. Clinical and pathological outcomes were compared across the three groups. Results: Of 2451 patients, 509 (20.8%) underwent RC. Patients with tumors > 3 cm or with CIS had earlier cystectomies (HR = 1.79, p = 0.001 and HR = 1.53, p = 0.02, respectively). Patients with tumors > 3 cm, multiple tumors or CIS had earlier T3/T4 or N + cystectomies. In patients who progressed, the timing of cystectomy did not affect the risk of T3/T4 or N + disease at RC. Patients with T3/T4 or N + disease at RC had a shorter disease-specific survival (HR = 4.38, p <0.001), as did patients with CIS at cystectomy (HR = 2.39, p <0.001). Patients who progressed prior to cystectomy had a shorter disease-specific survival than patients for whom progression was only detected at cystectomy (HR = 0.58, p = 0.024) Conclusions: Patients treated with RC before experiencing progression to muscle-invasive disease harbor better oncological and survival outcomes compared to those who progressed before RC and to those upstaged at surgery. Tumor size and concomitant CIS at diagnosis are the main predictors of surgical treatment while tumor size, CIS and tumor multiplicity are associated with extravesical disease at surgery. © 2018, Springer-Verlag GmbH Germany, part of Springer Nature.

AB - Purpose: To evaluate the oncological impact of postponing radical cystectomy (RC) to allow further conservative therapies prior to progression in a large multicentre retrospective cohort of T1-HG/G3 patients initially treated with BCG. Methods: According to the time of RC, the population was divided into 3 groups: patients who did not progress to muscle-invasive disease, patients who progressed before radical cystectomy and patients who experienced progression at the time of radical cystectomy. Clinical and pathological outcomes were compared across the three groups. Results: Of 2451 patients, 509 (20.8%) underwent RC. Patients with tumors > 3 cm or with CIS had earlier cystectomies (HR = 1.79, p = 0.001 and HR = 1.53, p = 0.02, respectively). Patients with tumors > 3 cm, multiple tumors or CIS had earlier T3/T4 or N + cystectomies. In patients who progressed, the timing of cystectomy did not affect the risk of T3/T4 or N + disease at RC. Patients with T3/T4 or N + disease at RC had a shorter disease-specific survival (HR = 4.38, p <0.001), as did patients with CIS at cystectomy (HR = 2.39, p <0.001). Patients who progressed prior to cystectomy had a shorter disease-specific survival than patients for whom progression was only detected at cystectomy (HR = 0.58, p = 0.024) Conclusions: Patients treated with RC before experiencing progression to muscle-invasive disease harbor better oncological and survival outcomes compared to those who progressed before RC and to those upstaged at surgery. Tumor size and concomitant CIS at diagnosis are the main predictors of surgical treatment while tumor size, CIS and tumor multiplicity are associated with extravesical disease at surgery. © 2018, Springer-Verlag GmbH Germany, part of Springer Nature.

U2 - 10.1007/s00345-018-2450-0

DO - 10.1007/s00345-018-2450-0

M3 - Article

VL - 36

SP - 1775

EP - 1781

JO - World Journal of Urology

JF - World Journal of Urology

SN - 0724-4983

IS - 11

ER -