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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
J. Palou, F. Pisano, R. Sylvester, S. Joniau, V. Serretta, S. Larré, S. Di Stasi, B. van Rhijn, AJ. Witjes, A. Grotenhuis, R. Colombo, A. Briganti, M. Babjuk, V. Soukup, PU. Malmstrom, J. Irani, N. Malats, J. Baniel, R. Mano, T. Cai, EK. Cha, P....
Jazyk angličtina Země Německo
Typ dokumentu časopisecké články
- MeSH
- adjuvancia imunologická terapeutické užití MeSH
- aplikace intravezikální MeSH
- BCG vakcína terapeutické užití MeSH
- cystektomie metody MeSH
- lidé MeSH
- lokální recidiva nádoru mortalita MeSH
- nádory močového měchýře * mortalita patologie terapie MeSH
- následné studie MeSH
- příčina smrti MeSH
- progrese nemoci MeSH
- proporcionální rizikové modely MeSH
- reoperace MeSH
- retrospektivní studie MeSH
- senioři MeSH
- staging nádorů MeSH
- Check Tag
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
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.
Department of Biostatistics EORTC Headquarters Brussels Belgium
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 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 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 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
Genetic and Molecular Epidemiology Group Spanish National Cancer Research Centre Madrid Spain
Citace poskytuje Crossref.org
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- $a Palou, J $u Department of Urology, Fundacio Puigvert, University of Barcelona, Barcelona, Spain.
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- $a 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 / $c J. Palou, F. Pisano, R. Sylvester, S. Joniau, V. Serretta, S. Larré, S. Di Stasi, B. van Rhijn, AJ. Witjes, A. Grotenhuis, R. Colombo, A. Briganti, M. Babjuk, V. Soukup, PU. Malmstrom, J. Irani, N. Malats, J. Baniel, R. Mano, T. Cai, EK. Cha, P. Ardelt, J. Varkarakis, R. Bartoletti, G. Dalbagni, SF. Shariat, E. Xylinas, RJ. Karnes, P. Gontero,
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- $a 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.
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