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Prognostic factors and risk groups in T1G3 non-muscle-invasive bladder cancer patients initially treated with Bacillus Calmette-Guérin: results of a retrospective multicenter study of 2451 patients
P. Gontero, R. Sylvester, F. Pisano, S. Joniau, K. Vander Eeckt, V. Serretta, S. Larré, S. Di Stasi, B. Van Rhijn, AJ. Witjes, AJ. Grotenhuis, LA. Kiemeney, R. Colombo, A. Briganti, M. Babjuk, PU. Malmström, M. Oderda, J. Irani, N. Malats, J....
Jazyk angličtina Země Švýcarsko
Typ dokumentu časopisecké články, multicentrická studie, práce podpořená grantem
- MeSH
- adjuvancia imunologická terapeutické užití MeSH
- BCG vakcína terapeutické užití MeSH
- cystektomie MeSH
- hodnocení rizik MeSH
- karcinom in situ komplikace MeSH
- lidé středního věku MeSH
- lidé MeSH
- lokální recidiva nádoru patologie chirurgie MeSH
- míra přežití MeSH
- nádory močového měchýře farmakoterapie patologie chirurgie MeSH
- následné studie MeSH
- prognóza MeSH
- progrese nemoci MeSH
- retrospektivní studie MeSH
- rizikové faktory MeSH
- senioři MeSH
- tumor burden MeSH
- věkové faktory MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- multicentrická studie MeSH
- práce podpořená grantem MeSH
BACKGROUND: The impact of prognostic factors in T1G3 non-muscle-invasive bladder cancer (BCa) patients is critical for proper treatment decision making. OBJECTIVE: To assess prognostic factors in patients who received bacillus Calmette-Guérin (BCG) as initial intravesical treatment of T1G3 tumors and to identify a subgroup of high-risk patients who should be considered for more aggressive treatment. DESIGN, SETTING, AND PARTICIPANTS: Individual patient data were collected for 2451 T1G3 patients from 23 centers who received BCG between 1990 and 2011. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: Using Cox multivariable regression, the prognostic importance of several clinical variables was assessed for time to recurrence, progression, BCa-specific survival, and overall survival (OS). RESULTS AND LIMITATIONS: With a median follow-up of 5.2 yr, 465 patients (19%) progressed, 509 (21%) underwent cystectomy, and 221 (9%) died because of BCa. In multivariable analyses, the most important prognostic factors for progression were age, tumor size, and concomitant carcinoma in situ (CIS); the most important prognostic factors for BCa-specific survival and OS were age and tumor size. Patients were divided into four risk groups for progression according to the number of adverse factors among age ≥ 70 yr, size ≥ 3 cm, and presence of CIS. Progression rates at 10 yr ranged from 17% to 52%. BCa-specific death rates at 10 yr were 32% in patients ≥ 70 yr with tumor size ≥ 3 cm and 13% otherwise. CONCLUSIONS: T1G3 patients ≥ 70 yr with tumors ≥ 3 cm and concomitant CIS should be treated more aggressively because of the high risk of progression. PATIENT SUMMARY: Although the majority of T1G3 patients can be safely treated with intravesical bacillus Calmette-Guérin, there is a subgroup of T1G3 patients with age ≥ 70 yr, tumor size ≥ 3 cm, and concomitant CIS who have a high risk of progression and thus require aggressive treatment.
Cochin Hospital Paris Descartes University Paris France
Department of Radiation Sciences Oncology Umeå University Umeå Sweden
Department of Surgical Science John Radcliffe Hospital University of Oxford Oxford UK
Department of Surgical Sciences Molinette Hospital University of Studies of Turin Turin Italy
Department of Surgical Sciences Uppsala University Uppsala Sweden
Department of Urology Comprehensive Cancer Center Medical University Vienna Vienna Austria
Department of Urology Fundacio Puigvert University of Barcelona Barcelona Spain
Department of Urology Mayo Clinic Rochester MN USA
Department of Urology Paolo Giaccone General Hospital Palermo Italy
Department of Urology Santa Chiara Hospital Trento Italy
Department of Urology Sismanoglio Hospital University of Athens Athens Greece
Department of Urology Spanish National Cancer Research Centre Madrid Madrid Spain
Department of Urology University Hospital of Wuerzburg Wuertzburg Germany
Dipartimento di Urologia Università Vita Salute Ospedale S Raffaele Milan Italy
EORTC Headquarters Brussels Belgium
Facharzt fur Urologie Abteilung fur Urologie Chirurgische Universitatsklinik Freiburg Germany
Policlinico Tor Vergata University of Rome Rome Italy
Urology Service Department of Surgery Memorial Sloan Kettering Cancer Center New York NY USA
Urology Unit S Maria Annunziata Hospital University of Florence Florence Italy
Citace poskytuje Crossref.org
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- $a Gontero, Paolo $u Department of Surgical Sciences, Molinette Hospital, University of Studies of Turin, Turin, Italy. Electronic address: paolo.gontero@unito.it.
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- $a BACKGROUND: The impact of prognostic factors in T1G3 non-muscle-invasive bladder cancer (BCa) patients is critical for proper treatment decision making. OBJECTIVE: To assess prognostic factors in patients who received bacillus Calmette-Guérin (BCG) as initial intravesical treatment of T1G3 tumors and to identify a subgroup of high-risk patients who should be considered for more aggressive treatment. DESIGN, SETTING, AND PARTICIPANTS: Individual patient data were collected for 2451 T1G3 patients from 23 centers who received BCG between 1990 and 2011. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: Using Cox multivariable regression, the prognostic importance of several clinical variables was assessed for time to recurrence, progression, BCa-specific survival, and overall survival (OS). RESULTS AND LIMITATIONS: With a median follow-up of 5.2 yr, 465 patients (19%) progressed, 509 (21%) underwent cystectomy, and 221 (9%) died because of BCa. In multivariable analyses, the most important prognostic factors for progression were age, tumor size, and concomitant carcinoma in situ (CIS); the most important prognostic factors for BCa-specific survival and OS were age and tumor size. Patients were divided into four risk groups for progression according to the number of adverse factors among age ≥ 70 yr, size ≥ 3 cm, and presence of CIS. Progression rates at 10 yr ranged from 17% to 52%. BCa-specific death rates at 10 yr were 32% in patients ≥ 70 yr with tumor size ≥ 3 cm and 13% otherwise. CONCLUSIONS: T1G3 patients ≥ 70 yr with tumors ≥ 3 cm and concomitant CIS should be treated more aggressively because of the high risk of progression. PATIENT SUMMARY: Although the majority of T1G3 patients can be safely treated with intravesical bacillus Calmette-Guérin, there is a subgroup of T1G3 patients with age ≥ 70 yr, tumor size ≥ 3 cm, and concomitant CIS who have a high risk of progression and thus require aggressive treatment.
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