High-Grade T1 on Re-Transurethral Resection after Initial High-Grade T1 Confers Worse Oncological Outcomes: Results of a Multi-Institutional Study

被引：26

作者：

Ferro, Matteo ^{[1
]}

Vartolomei, Mihai Dorin ^{[1
,2
,3
]}

Cantiello, Francesco ^{[4
]}

Lucarelli, Giuseppe ^{[5
]}

Di Stasi, Savino M. ^{[6
]}

Hurle, Rodolfo ^{[7
]}

Guazzoni, Giorgio ^{[7
]}

Busetto, Gian Maria ^{[8
]}

De Berardinis, Ettore ^{[8
]}

Damiano, Rocco ^{[4
]}

Perdona, Sisto ^{[9
]}

Borghesi, Marco ^{[10
]}

Schiavina, Riccardo ^{[10
]}

Almeida, Gilberto L. ^{[11
]}

Bove, Pierluigi ^{[12
]}

Lima, Estevao ^{[13
]}

Grimaldi, Giovanni ^{[13
]}

Autorino, Riccardo ^{[14
]}

Crisan, Nicolae ^{[15
]}

Abu Farhan, Abdal Rahman ^{[4
]}

Verze, Paolo ^{[16
]}

Battaglia, Michele ^{[5
]}

Serretta, Vincenzo ^{[17
]}

Russo, Giorgio Ivan ^{[18
]}

Morgia, Giuseppe ^{[18
]}

Musi, Gennaro ^{[1
]}

de Cobelli, Ottavio ^{[1
,19
]}

Mirone, Vincenzo ^{[16
]}

Shariat, Shahrokh F. ^{[2
,20
,21
,22
]}

机构：

[1] European Inst Oncol, Div Urol, Via Ripamonti 435, IT-20141 Milan, Italy

[2] Med Univ Vienna, Dept Urol, Vienna, Austria

[3] Univ Med & Pharm, Dept Cell & Mol Biol, Targu Mures, Romania

[4] Magna Graecia Univ Catanzaro, Dept Urol, Catanzaro, Italy

[5] Univ Bari, Dept Emergency & Organ Transplantat, Urol Androl & Kidney Transplantat Unit, Bari, Italy

[6] Tor Vegata Univ, Dept Expt Med & Surg, Rome, Italy

[7] Humanitas Univ, Dept Biomed Sci, Clin & Res Hosp, Dept Urol,Ist Clin Humanitas IRCCS, Milan, Italy

[8] Sapienza Univ Rome, Dept Urol, Rome, Italy

[9] Fdn G Pascale IRCCS, Ist Nazl Studio & Cura Tumori, Urogynecol Dept, Naples, Italy

[10] Univ Bologna, Dept Urol, Bologna, Italy

[11] Univ Vale Itajai, Dept Urol, Itajai, Brazil

[12] Tor Vergata Univ Rome, UOC Urol Dept Expt Med & Surg, Rome, Italy

[13] Univ Minho, Life & Hlth Sci Res Inst, Braga, Portugal

[14] Virginia Commonwealth Univ, Div Urol, Richmond, VA USA

[15] Univ Med & Pharm Iuliu Hatieganu, Dept Urol, Cluj Napoca, Romania

[16] Univ Naples Federico II, Urol Unit, Dept Neurosci, Sci Reprod & Odontostomatol, Naples, Italy

[17] Univ Palermo, Dept Surg Oncol & Stomatol Sci, Palermo, Italy

[18] Univ Catania, Dept Surg, Urol Sect, Catania, Italy

[19] Univ Milan, Via Festa del Perdono 7, Milan, Italy

[20] Karl Landsteiner Inst Urol & Androl, Vienna, Austria

[21] Univ Texas Southwestern Med Ctr Dallas, Dept Urol, Dallas, TX 75390 USA

[22] Weill Cornell Med Coll, Dept Urol, New York, NY USA

来源：

UROLOGIA INTERNATIONALIS | 2018年 / 101卷 / 01期

关键词：

High-grade; Bladder cancer; High risk; Transurethral resection of bladder tumor; Second look resection; BACILLUS-CALMETTE-GUERIN; INVASIVE BLADDER-CANCER; UROTHELIAL CARCINOMA; CLINICAL-OUTCOMES; EARLY CYSTECTOMY; PROGRESSION; IMPACT; RECURRENCE; EXPRESSION; GUIDELINES;

D O I：

10.1159/000490765

中图分类号：

R5 [内科学]; R69 [泌尿科学（泌尿生殖系疾病）];

学科分类号：

1002 ; 100201 ;

摘要：

Introduction: The aim of this multicenter study was to investigate the prognostic impact of residual T1 high-grade (HG)/G3 tumors at re-transurethral resection (TUR of bladder tumor) in a large multi-institutional cohort of patients with primary T1 HG/G3 bladder cancer (BC). Patients and Methods: The study period was from January 2002 to December 2012. A total of 1,046 patients with primary T1 HG/G3 and who had non-muscle invasive BC (NMIBC) on reTUR followed by adjuvant intravesical Bacillus Calmette-Guerin (BCG) therapy with maintenance were included. Endpoints were time to disease recurrence, progression, and overall and cancer-specific death. Results: A total of 257 (24.6%) patients had residual T1 HG/G3 tumors. The presence of concomitant carcinoma in situ, multiple and large tumors (> 3 cm) at first TUR were associated with residual T1 HG/G3. Five-year recurrence-free survival (RFS), progression-free survival (PFS), overall survival (OS), and cancerspecific survival (CSS) were 17% (CI 11.8-23); 58.2% (CI 50.765); 73.7% (CI 66.3-79.7); and 84.5% (CI 77.8-89.3), respectively, in patients with residual T1 HG/G3, compared to 36.7% (CI 32.8-40.6); 71.4% (CI 67.3-75.2); 89.8% (CI 86.692.3); and 95.7% (CI 93.4-97.3), respectively, in patients with NMIBC other than T1 HG/G3 or T0 tumors. Residual T1 HG/G3 was independently associated with RFS, PFS, OS, and CSS in multivariable analyses. Conclusions: Residual T1 HG/G3 tumor at re-TUR confers worse prognosis in patients with primary T1 HG/G3 treated with maintenance BCG. Patients with residual T1 HG/G3 for primary T1 HG/G3 are very likely to fail BCG therapy alone. (C) 2018 S. Karger AG, Basel

引用

页码：7 / 15

页数：9

共 41 条

[1] Is restaging transurethral resection necessary in patients with non-muscle invasive bladder cancer and limited lamina propria invasion? [J].