TY - JOUR
T1 - 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.
AU - Krajewski, Wojciech
AU - Moschini, Marco
AU - Nowak, Łukasz
AU - Poletajew, Sławomir
AU - Tukiendorf, Andrzej
AU - Afferi, Luca
AU - Teoh, Jeremy
AU - Muilwijk, Tim
AU - Joniau, Steven
AU - Tafuri, Alessandro
AU - Antonelli, Alessandro
AU - Gozzo, Alessandra
AU - Mari, Andrea
AU - Di Trapani, Ettore
AU - Hendricksen, Kees
AU - Alvarez-Maestro, Mario
AU - Rodriguez Serrano, Andrea
AU - Simone, Giuseppe
AU - Zamboni, Stefania
AU - Simeone, Claudio
AU - Marconi, Maria Cristina
AU - Mastroianni, Riccardo
AU - Ploussard, Guillaume
AU - Rajwa, Paweł
AU - Laukhtina, Ekaterina
AU - Zdrojowy-Wełna, Aleksandra
AU - Kołodziej, Anna
AU - Paradysz, Andrzej
AU - Tully, Karl
AU - Krajewska, Joanna
AU - Piszczek, Radosław
AU - Xylinas, Evanguelos
AU - Zdrojowy, Romuald
PY - 2020/10/15
Y1 - 2020/10/15
N2 - 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.
AB - 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.
KW - BCG
KW - bladder cancer
KW - reTURB
U2 - 10.3390/jcm9103306
DO - 10.3390/jcm9103306
M3 - Article
VL - 9
JO - Journal of Clinical Medicine
JF - Journal of Clinical Medicine
SN - 2077-0383
IS - 10
M1 - 3306
ER -