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

J Palou, F Pisano, R Sylvester, S Joniau, V Serretta, S Larré, S Di Stasi, B van Rhijn, AJ Witjes, A Grotenhuis, R Colombo, A Briganti, M Babjuk, V Soukup, PU Malmstrom, J Irani, N Malats, J Baniel, R Mano, T Cai & 9 others EK Cha, P Ardelt, J Varkarakis, R Bartoletti, G Dalbagni, SF Shariat, E Xylinas, RJ Karnes, P Gontero

Research output: Contribution to journalArticle

Abstract

Purpose: The 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. Methods: In 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. Results: During a median follow-up of 5.2 years, 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. Conclusions: Patients 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. © 2018, Springer-Verlag GmbH Germany, part of Springer Nature.
Original languageEnglish
Pages (from-to)1621-1627
Number of pages7
JournalWorld Journal of Urology
Volume36
Issue number10
DOIs
Publication statusPublished - 2018

Fingerprint

Mycobacterium bovis
Urinary Bladder Neoplasms
Recurrence
Mortality
Neoplasms
Residual Neoplasm
Muscles
Proportional Hazards Models
Germany

Cite this

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

In: World Journal of Urology, Vol. 36, No. 10, 2018, p. 1621-1627.

Research output: Contribution to journalArticle

Palou, J, Pisano, F, Sylvester, R, Joniau, S, Serretta, V, Larré, S, Di Stasi, S, van Rhijn, B, Witjes, AJ, Grotenhuis, A, Colombo, R, Briganti, A, Babjuk, M, Soukup, V, Malmstrom, PU, Irani, J, Malats, N, Baniel, J, Mano, R, Cai, T, Cha, EK, Ardelt, P, Varkarakis, J, Bartoletti, R, Dalbagni, G, Shariat, SF, Xylinas, E, Karnes, RJ & Gontero, P 2018, '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', World Journal of Urology, vol. 36, no. 10, pp. 1621-1627. https://doi.org/10.1007/s00345-018-2299-2
Palou, J ; Pisano, F ; Sylvester, R ; Joniau, S ; Serretta, V ; Larré, S ; Di Stasi, S ; van Rhijn, B ; Witjes, AJ ; Grotenhuis, A ; Colombo, R ; Briganti, A ; Babjuk, M ; Soukup, V ; Malmstrom, PU ; Irani, J ; Malats, N ; Baniel, J ; Mano, R ; Cai, T ; Cha, EK ; Ardelt, P ; Varkarakis, J ; Bartoletti, R ; Dalbagni, G ; Shariat, SF ; Xylinas, E ; Karnes, RJ ; Gontero, P. / 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. In: World Journal of Urology. 2018 ; Vol. 36, No. 10. pp. 1621-1627.
@article{77736f4f459a4fddbefbbfba550f2c49,
title = "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",
abstract = "Purpose: The 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. Methods: In 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. Results: During a median follow-up of 5.2 years, 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. Conclusions: Patients 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. {\circledC} 2018, Springer-Verlag GmbH Germany, part of Springer Nature.",
author = "J Palou and F Pisano and R Sylvester and S Joniau and V Serretta and S Larr{\'e} and {Di Stasi}, S and {van Rhijn}, B and AJ 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 EK Cha and P Ardelt and J Varkarakis and R Bartoletti and G Dalbagni and SF Shariat and E Xylinas and RJ Karnes and P Gontero",
year = "2018",
doi = "10.1007/s00345-018-2299-2",
language = "English",
volume = "36",
pages = "1621--1627",
journal = "World Journal of Urology",
issn = "0724-4983",
publisher = "Springer Verlag",
number = "10",

}

TY - JOUR

T1 - 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

AU - Palou, J

AU - Pisano, F

AU - Sylvester, R

AU - Joniau, S

AU - Serretta, V

AU - Larré, S

AU - Di Stasi, S

AU - van Rhijn, B

AU - Witjes, AJ

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, EK

AU - Ardelt, P

AU - Varkarakis, J

AU - Bartoletti, R

AU - Dalbagni, G

AU - Shariat, SF

AU - Xylinas, E

AU - Karnes, RJ

AU - Gontero, P

PY - 2018

Y1 - 2018

N2 - Purpose: The 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. Methods: In 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. Results: During a median follow-up of 5.2 years, 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. Conclusions: Patients 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. © 2018, Springer-Verlag GmbH Germany, part of Springer Nature.

AB - Purpose: The 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. Methods: In 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. Results: During a median follow-up of 5.2 years, 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. Conclusions: Patients 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. © 2018, Springer-Verlag GmbH Germany, part of Springer Nature.

U2 - 10.1007/s00345-018-2299-2

DO - 10.1007/s00345-018-2299-2

M3 - Article

VL - 36

SP - 1621

EP - 1627

JO - World Journal of Urology

JF - World Journal of Urology

SN - 0724-4983

IS - 10

ER -