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, A. J. Witjes, A. Grotenhuis, R. Colombo, A. Briganti, M. Babjuk, V. Soukup, P. U. Malmstrom, J. Irani, N. Malats, J. Baniel, R. Mano, T. CaiE. K. Cha, P. Ardelt, J. Varkarakis, R. Bartoletti, G. Dalbagni, S. F. Shariat, E. Xylinas, Robert Jeffrey Karnes, P. Gontero

Research output: Contribution to journalArticle

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Abstract

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.

Original languageEnglish (US)
Pages (from-to)1621-1627
Number of pages7
JournalWorld Journal of Urology
Volume36
Issue number10
DOIs
StatePublished - Oct 1 2018

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Mycobacterium bovis
Urinary Bladder Neoplasms
Recurrence
Mortality
Neoplasms
Residual Neoplasm
Muscles
Proportional Hazards Models

Keywords

  • Non-muscle invasive bladder cancer
  • Progression
  • Re-transurethral resection of the bladder
  • Recurrence

ASJC Scopus subject areas

  • Urology

Cite this

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. / Palou, J.; Pisano, F.; Sylvester, R.; Joniau, S.; Serretta, V.; Larré, S.; Di Stasi, S.; van Rhijn, B.; Witjes, A. J.; Grotenhuis, A.; Colombo, R.; Briganti, A.; Babjuk, M.; Soukup, V.; Malmstrom, P. U.; Irani, J.; Malats, N.; Baniel, J.; Mano, R.; Cai, T.; Cha, E. K.; Ardelt, P.; Varkarakis, J.; Bartoletti, R.; Dalbagni, G.; Shariat, S. F.; Xylinas, E.; Karnes, Robert Jeffrey; Gontero, P.

In: World Journal of Urology, Vol. 36, No. 10, 01.10.2018, p. 1621-1627.

Research output: Contribution to journalArticle

Palou, J, Pisano, F, Sylvester, R, Joniau, S, Serretta, V, Larré, S, Di Stasi, S, van Rhijn, B, Witjes, AJ, Grotenhuis, A, Colombo, R, Briganti, A, Babjuk, M, Soukup, V, Malmstrom, PU, Irani, J, Malats, N, Baniel, J, Mano, R, Cai, T, Cha, EK, Ardelt, P, Varkarakis, J, Bartoletti, R, Dalbagni, G, Shariat, SF, Xylinas, E, Karnes, RJ & Gontero, P 2018, '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', World Journal of Urology, vol. 36, no. 10, pp. 1621-1627. https://doi.org/10.1007/s00345-018-2299-2
Palou, J. ; Pisano, F. ; Sylvester, R. ; Joniau, S. ; Serretta, V. ; Larré, S. ; Di Stasi, S. ; van Rhijn, B. ; Witjes, A. J. ; Grotenhuis, A. ; Colombo, R. ; Briganti, A. ; Babjuk, M. ; Soukup, V. ; Malmstrom, P. U. ; Irani, J. ; Malats, N. ; Baniel, J. ; Mano, R. ; Cai, T. ; Cha, E. K. ; Ardelt, P. ; Varkarakis, J. ; Bartoletti, R. ; Dalbagni, G. ; Shariat, S. F. ; Xylinas, E. ; Karnes, Robert Jeffrey ; Gontero, P. / 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. In: World Journal of Urology. 2018 ; Vol. 36, No. 10. pp. 1621-1627.
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abstract = "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.",
keywords = "Non-muscle invasive bladder cancer, Progression, Re-transurethral resection of the bladder, Recurrence",
author = "J. Palou and F. Pisano and R. Sylvester and S. Joniau and V. Serretta and S. Larr{\'e} and {Di Stasi}, S. and {van Rhijn}, B. and Witjes, {A. J.} and A. Grotenhuis and R. Colombo and A. Briganti and M. Babjuk and V. Soukup and Malmstrom, {P. U.} and J. Irani and N. Malats and J. Baniel and R. Mano and T. Cai and Cha, {E. K.} and P. Ardelt and J. Varkarakis and R. Bartoletti and G. Dalbagni and Shariat, {S. F.} and E. Xylinas and Karnes, {Robert Jeffrey} and P. Gontero",
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T1 - Recurrence, progression and cancer-specific mortality according to stage at re-TUR in T1G3 bladder cancer patients treated with BCG

T2 - not as bad as previously thought

AU - Palou, J.

AU - Pisano, F.

AU - Sylvester, R.

AU - Joniau, S.

AU - Serretta, V.

AU - Larré, S.

AU - Di Stasi, S.

AU - van Rhijn, B.

AU - Witjes, A. J.

AU - Grotenhuis, A.

AU - Colombo, R.

AU - Briganti, A.

AU - Babjuk, M.

AU - Soukup, V.

AU - Malmstrom, P. U.

AU - Irani, J.

AU - Malats, N.

AU - Baniel, J.

AU - Mano, R.

AU - Cai, T.

AU - Cha, E. K.

AU - Ardelt, P.

AU - Varkarakis, J.

AU - Bartoletti, R.

AU - Dalbagni, G.

AU - Shariat, S. F.

AU - Xylinas, E.

AU - Karnes, Robert Jeffrey

AU - Gontero, P.

PY - 2018/10/1

Y1 - 2018/10/1

N2 - 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.

AB - 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.

KW - Non-muscle invasive bladder cancer

KW - Progression

KW - Re-transurethral resection of the bladder

KW - Recurrence

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