Impact of tumor size on the oncological outcome of high-grade nonmuscle invasive bladder cancer - examining the utility of classifying Ta bladder cancer based on size
Jazyk angličtina Země Spojené státy americké Médium print-electronic
Typ dokumentu časopisecké články, multicentrická studie
PubMed
32739227
DOI
10.1016/j.urolonc.2020.06.034
PII: S1078-1439(20)30321-5
Knihovny.cz E-zdroje
- Klíčová slova
- Bladder cancer, Non-muscle invasive, Outcome, Recurrence and progression, Risk stratification, Urothelial carcinoma,
- MeSH
- hodnocení rizik MeSH
- invazivní růst nádoru MeSH
- lidé středního věku MeSH
- lidé MeSH
- lokální recidiva nádoru epidemiologie MeSH
- míra přežití MeSH
- nádory močového měchýře klasifikace mortalita patologie MeSH
- progrese nemoci MeSH
- retrospektivní studie MeSH
- senioři MeSH
- směrnice pro lékařskou praxi jako téma MeSH
- stupeň nádoru MeSH
- tumor burden 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 examine survival rates and to calculate the risk of disease recurrence, progression, overall, and cancer-specific mortality in patients diagnosed with high-risk NMIBC using a multi-institutional dataset to evaluate differences between the guidelines of the European Association of Urology and the guidelines of the National Comprehensive Cancer Network (NCCN) with regard to tumor size in risk stratification. METHODS AND MATERIAL: In total 1,116 individuals diagnosed with high-risk NMIBC between 2001 and 2013 were included in the analysis. Patients were stratified to NCCN guideline recommendations (high-grade T1, high-grade Ta ≤ 3 cm, and high-grade Ta > 3 cm). Recurrence and progression rates were calculated. Kaplan-Meier curves were fitted to examine differences in recurrence-free (RFS) and progression-free survival (PFS). Multivariable Cox proportional hazards regression models were employed to calculate differences in the RFS, PFS, overall, and cancer-specific survival (CSS). RESULTS: The majority of patients were diagnosed with high-grade T1 disease (N = 576, 51.6%), while 34.2% and 14.2% of patients were diagnosed with high-grade Ta ≤ 3 cm and Ta > 3 cm NMIBC, respectively. The 1- and 5-year RFS (1-year: 80.5% vs. 64.9%; 5-year: 58.6% vs. 48.3%, P = 0.048) and PFS (1-year: 99.1% vs. 98.6%; 5-year: 97.7% vs. 92.4%, P = 0.054) rates were higher in patients with Ta ≤ 3 cm. Patients diagnosed with high-grade Ta > 3 cm experienced unfavorable progression-free, and cancer-specific survival compared to high-grade Ta ≤ 3 cm, respectively (PFS: 2.41, 95% confidence interval [CI] 1.05-5.56, P = 0.038; CSS: hazard ratios [HR] 2.22, 95% CI 1.02-4.89, P = 0.048). CONCLUSION: Patients diagnosed with high-grade Ta NMIBC ≤3 cm demonstrated a favorable progression-free, and cancer-specific survival compared to patients diagnosed with high-grade Ta > 3 cm and high-grade T1 NMIBC.
Department of Medicine Fondazione IRCCS Istituto Nazionale dei Tumori Milan Italy
Department of Urology and Oncological Urology Wrocław Medical University Wrocław Poland
Department of Urology Comprehensive Cancer Center Medical University of Vienna Vienna Austria
Department of Urology Jena University Hospital Friedrich Schiller University Jena Germany
Department of Urology München Klinik Bogenhausen Munich Germany
Department of Urology Ruhr University Bochum Marien Hospital Herne Germany
Department of Urology The Netherlands Cancer Institute Amsterdam The Netherlands
Department of Urology University Hospital Frankfurt Frankfurt am Main Germany
Department of Urology University Hospital Zürich University of Zürich Zürich Switzerland
Department of Urology University Medical Center Hamburg Eppendorf Hamburg Germany
Department of Urology University of Bern Bern Switzerland
Division of Radiation Oncology McGill University Montreal QC Canada
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