Restaging Transurethral Resection of Bladder Tumours after BCG Immunotherapy Induction in Patients with T1 Non-Muscle-Invasive Bladder Cancer Might not Be Associated with Oncologic Benefit.

Wojciech Krajewski, Marco Moschini, Łukasz Nowak, Sławomir Poletajew, Andrzej Tukiendorf, Luca Afferi, Jeremy Teoh, Tim Muilwijk, Steven Joniau, Alessandro Tafuri, Alessandro Antonelli, Alessandra Gozzo, Andrea Mari, Ettore Di Trapani, Kees Hendricksen, Mario Alvarez-Maestro, Andrea Rodriguez Serrano, Giuseppe Simone, Stefania Zamboni, Claudio SimeoneMaria Cristina Marconi, Riccardo Mastroianni, Guillaume Ploussard, Paweł Rajwa, Ekaterina Laukhtina, Aleksandra Zdrojowy-Wełna, Anna Kołodziej, Andrzej Paradysz, Karl Tully, Joanna Krajewska, Radosław Piszczek, Evanguelos Xylinas, Romuald Zdrojowy

Research output: Contribution to journalArticlepeer-review

Abstract

Background and purpose: The European Association of Urology guidelines recommend restaging transurethral resection of bladder tumours (reTURB) 2-6 weeks after primary TURB. However, in clinical practice some patients undergo a second TURB procedure after Bacillus Calmette-Guérin immunotherapy (BCG)induction. To date, there are no studies comparing post-BCG reTURB with the classic pre-BCG approach. The aim of this study was to assess whether the performance of reTURB after BCG induction in T1HG bladder cancer is related to potential oncological benefits. Materials and methods: Data from 645 patients with primary T1HG bladder cancer treated between 2001 and 2019 in 12 tertiary care centres were retrospectively reviewed. The study included patients who underwent reTURB before BCG induction (Pre-BCG group: 397 patients; 61.6%) and those who had reTURB performed after BCG induction (Post-BCG group: 248 patients, 38.4%). The decision to perform reTURB before or after BCG induction was according to the surgeon's discretion, as well as a consideration of local proceedings and protocols. Due to variation in patients' characteristics, both propensity-score-matched analysis (PSM) and inverse-probability weighting (IPW) were implemented. Results: The five-year recurrence-free survival (RFS) was 64.7% and 69.1% for the Pre- and Post-BCG groups, respectively, and progression-free survival (PFS) was 82.7% and 83.3% for the Pre- and Post-BCG groups, respectively (both: p > 0.05). Similarly, neither RFS nor PFS differed significantly for a five-year period or in the whole time of observation after the PSM and IPW matching methods were used. Conclusions: Our results suggest that there might be no difference in recurrence-free survival and progression-free survival rates, regardless of whether patients have reTURB performed before or after BCG induction.
Original languageEnglish
Article number3306
Number of pages12
JournalJournal of Clinical Medicine
Volume9
Issue number10
DOIs
Publication statusPublished - Oct 15 2020

Keywords

  • BCG
  • bladder cancer
  • reTURB

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