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 -