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The role of re-transurethral resection of bladder tumor in patients with TaHG non muscle invasive bladder cancer
P. Scilipoti, M. Moschini, M. de Angelis, L. Afferi, C. Lonati, M. Longoni, G. Tremolada, P. Zaurito, A. Viti, A. Santangelo, R. Pichler, A. Necchi, F. Montorsi, A. Briganti, A. Mari, W. Krajewski, E. Laukthina, B. Pradere, F. Del Giudice, L....
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
- cystektomie * metody MeSH
- invazivní růst nádoru * MeSH
- lidé středního věku MeSH
- lidé MeSH
- lokální recidiva nádoru epidemiologie MeSH
- nádory močového měchýře * chirurgie patologie MeSH
- reoperace MeSH
- retrospektivní studie MeSH
- senioři MeSH
- stupeň nádoru MeSH
- transuretrální resekce močového měchýře MeSH
- uretra 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: There is lack of evidence regarding the indication for re-transurethral resection of bladder tumor (reTURBT) for Ta high grade (HG) non-muscle invasive bladder cancer (NMIBC). This study aims to evaluate the oncological outcomes of patients with TaHG NMIBC to determine the benefit from performing reTURBT. METHODS: We relied on a multicenter cohort of 317 TaHG NMIBC from 12 centers who underwent TURBT and a subsequent complete Bacillus Calmette-Guérin induction from 2009 to 2021. Kaplan Meier analyses estimated recurrence free survival (RFS) and progression free survival (PFS) according to reTURBT. Sub-analyses evaluated PFS in patients with multiple risk factors indicating necessity for reTURBT according to international guidelines (multifocality, size > 3 cm, recurrent cancer, carcinoma in situ, lymph vascular invasion, histological variant, incomplete and absence of muscle layer at index TURBT). Multivariable cox-regression analysis predicted recurrence and progression. RESULTS: Of the 317 patients, 123 (39%) underwent reTURBT, while 194 (61%) did not. Residual disease was detected in 46% of cases, with a 3.2% upstaging rate. Median follow-up was 30 months. The 3-year RFS was higher in patients who underwent reTURBT (79% vs. 58%, p < 0.001), but no significant difference was observed in PFS. ReTURBT reduced the risk of recurrence [multivariable hazard ratio: 0.45, 95% Confidence interval (CI) 0.29-0.71]. Among patients who did not undergo reTURBT, those with ≥ 2 risk factors had lower 3-year PFS (73% vs. 92%, p < 0.001) than those with 0-1 risk factor, whereas no difference in 3-year PFS was observed in patients who underwent reTURBT regardless of the number of risk factors (85% vs. 87%, p = 0.8). CONCLUSION: ReTURBT demonstrated efficacy in reducing recurrence among patients with TaHG NMIBC, yet its impact on progression remained uncertain. Our study underscores the importance of adhering to current international guidelines, particularly for patients with multiple risk factors indicating necessity for reTURBT.
Belegarzt für Urologie Luzerner Kantonsspital Lucerne Switzerland
Clinica Luganese Moncucco Lugano Switzerland
Department of Urology 2nd Faculty of Medicine Charles University Prague Czech Republic
Department of Urology and Oncologic Urology Wrocław Medical University Wroclaw Poland
Department of Urology Careggi Hospital University of Florence Florence Italy
Department of Urology Luzerner Kantonsspital Lucerne Switzerland
Department of Urology Medical University of Innsbruck Innsbruck Austria
Department of Urology Netherlands Cancer Institute 1066 CX Amsterdam Netherlands
Department of Urology Puigvert Foundation Autonomous University of Barcelona Barcelona Spain
Department of Urology Spedali Civili Hospital University of Brescia Brescia Italy
Department of Urology University of Texas Southwestern Dallas TX USA
Department of Urology University of Tor Vergata Rome Italy
Department of Urology UROSUD La Croix Du Sud Hospital Quint Fonsegrives France
Department of Urology Weill Cornell Medical College New York NY USA
Division of Urology Department of Surgical Sciences Torino School of Medicine Turin Italy
Karl Landsteiner Institute of Urology and Andrology Vienna Austria
Citace poskytuje Crossref.org
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