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Predictors of oncological outcomes in T1G3 patients treated with BCG who undergo radical cystectomy
F. Soria, F. Pisano, P. Gontero, J. Palou, S. Joniau, V. Serretta, S. Larré, S. Di Stasi, B. van Rhijn, JA. Witjes, A. Grotenhuis, R. Colombo, A. Briganti, M. Babjuk, V. Soukup, PU. Malmstrom, J. Irani, N. Malats, J. Baniel, R. Mano, T. Cai, E....
Jazyk angličtina Země Německo
Typ dokumentu časopisecké články, multicentrická studie
NLK
ProQuest Central
od 1997-02-01 do Před 1 rokem
Medline Complete (EBSCOhost)
od 2000-02-01 do Před 1 rokem
Health & Medicine (ProQuest)
od 1997-02-01 do Před 1 rokem
- MeSH
- analýza přežití MeSH
- BCG vakcína terapeutické užití MeSH
- cystektomie metody MeSH
- hodnocení rizik MeSH
- invazivní růst nádoru patologie MeSH
- Kaplanův-Meierův odhad MeSH
- karcinom z přechodných buněk farmakoterapie mortalita patologie chirurgie MeSH
- kohortové studie MeSH
- lidé středního věku MeSH
- lidé MeSH
- lokální recidiva nádoru mortalita patologie terapie MeSH
- multivariační analýza MeSH
- nádory močového měchýře farmakoterapie mortalita patologie chirurgie MeSH
- přežití po terapii bez příznaků nemoci MeSH
- prognóza MeSH
- proporcionální rizikové modely MeSH
- retrospektivní studie MeSH
- senioři MeSH
- staging nádorů MeSH
- výsledek terapie 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
PURPOSE: To evaluate the oncological impact of postponing radical cystectomy (RC) to allow further conservative therapies prior to progression in a large multicentre retrospective cohort of T1-HG/G3 patients initially treated with BCG. METHODS: According to the time of RC, the population was divided into 3 groups: patients who did not progress to muscle-invasive disease, patients who progressed before radical cystectomy and patients who experienced progression at the time of radical cystectomy. Clinical and pathological outcomes were compared across the three groups. RESULTS: Of 2451 patients, 509 (20.8%) underwent RC. Patients with tumors > 3 cm or with CIS had earlier cystectomies (HR = 1.79, p = 0.001 and HR = 1.53, p = 0.02, respectively). Patients with tumors > 3 cm, multiple tumors or CIS had earlier T3/T4 or N + cystectomies. In patients who progressed, the timing of cystectomy did not affect the risk of T3/T4 or N + disease at RC. Patients with T3/T4 or N + disease at RC had a shorter disease-specific survival (HR = 4.38, p < 0.001), as did patients with CIS at cystectomy (HR = 2.39, p < 0.001). Patients who progressed prior to cystectomy had a shorter disease-specific survival than patients for whom progression was only detected at cystectomy (HR = 0.58, p = 0.024) CONCLUSIONS: Patients treated with RC before experiencing progression to muscle-invasive disease harbor better oncological and survival outcomes compared to those who progressed before RC and to those upstaged at surgery. Tumor size and concomitant CIS at diagnosis are the main predictors of surgical treatment while tumor size, CIS and tumor multiplicity are associated with extravesical disease at surgery.
Città della Salute e della Scienza di Torino University of Studies of Turin Turin Italy
Department of Experimental and Clinical Medicine University of Florence Florence Italy
Department of Surgical Oncological and Stomatological Sciences University of Palermo Palermo Italy
Department of Surgical Science John Radcliffe Hospital University of Oxford Oxford UK
Department of Urology Academic Hospital Uppsala University Uppsala Sweden
Department of Urology CHU de Bicêtre 78 rue du Général Leclerc 94270 Le Kremlin Bicêtre France
Department of Urology Cochin Hospital Paris France
Department of Urology Fundacio Puigvert University of Barcelona Barcelona Spain
Department of Urology Mayo Clinic Rochester MN USA
Department of Urology Medical University of Vienna Vienna Austria
Department of Urology Memorial Sloan Kettering Cancer Center New York NY USA
Department of Urology Motol Hospital University of Praha Prague Czech Republic
Department of Urology Rabin Medical Centre Tel Aviv Israel
Department of Urology Radboud University Nijmegen Medical Centre Nijmegen The Netherlands
Department of Urology Santa Chiara Hospital Trento Italy
Department of Urology Sismanoglio Hospital University of Athens Athens Greece
Department of Urology Weill Medical College of Cornell University in New York City New York NY USA
Dipartimento di Urologia Università Vita Salute Ospedale S Raffaele Milan Italy
Facharzt fur Urologie Abteilung fur Urologie Chirurgische Universitats klinik Freiburg Germany
Formerly Department of Biostatistics EORTC Headquarters Brussels Belgium
Genetic and Molecular Epidemiology Group Spanish National Cancer Research Centre Madrid Spain
Citace poskytuje Crossref.org
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- $a Soria, Francesco $u Department of Urology, Medical University of Vienna, Vienna, Austria.
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- $a Predictors of oncological outcomes in T1G3 patients treated with BCG who undergo radical cystectomy / $c F. Soria, F. Pisano, P. Gontero, J. Palou, S. Joniau, V. Serretta, S. Larré, S. Di Stasi, B. van Rhijn, JA. Witjes, A. Grotenhuis, R. Colombo, A. Briganti, M. Babjuk, V. Soukup, PU. Malmstrom, J. Irani, N. Malats, J. Baniel, R. Mano, T. Cai, E. Cha, P. Ardelt, J. Varkarakis, R. Bartoletti, G. Dalbagni, SF. Shariat, E. Xylinas, RJ. Karnes, R. Sylvester,
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- $a PURPOSE: To evaluate the oncological impact of postponing radical cystectomy (RC) to allow further conservative therapies prior to progression in a large multicentre retrospective cohort of T1-HG/G3 patients initially treated with BCG. METHODS: According to the time of RC, the population was divided into 3 groups: patients who did not progress to muscle-invasive disease, patients who progressed before radical cystectomy and patients who experienced progression at the time of radical cystectomy. Clinical and pathological outcomes were compared across the three groups. RESULTS: Of 2451 patients, 509 (20.8%) underwent RC. Patients with tumors > 3 cm or with CIS had earlier cystectomies (HR = 1.79, p = 0.001 and HR = 1.53, p = 0.02, respectively). Patients with tumors > 3 cm, multiple tumors or CIS had earlier T3/T4 or N + cystectomies. In patients who progressed, the timing of cystectomy did not affect the risk of T3/T4 or N + disease at RC. Patients with T3/T4 or N + disease at RC had a shorter disease-specific survival (HR = 4.38, p < 0.001), as did patients with CIS at cystectomy (HR = 2.39, p < 0.001). Patients who progressed prior to cystectomy had a shorter disease-specific survival than patients for whom progression was only detected at cystectomy (HR = 0.58, p = 0.024) CONCLUSIONS: Patients treated with RC before experiencing progression to muscle-invasive disease harbor better oncological and survival outcomes compared to those who progressed before RC and to those upstaged at surgery. Tumor size and concomitant CIS at diagnosis are the main predictors of surgical treatment while tumor size, CIS and tumor multiplicity are associated with extravesical disease at surgery.
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