Τίτλος:
The impact of re-transurethral resection on clinical outcomes in a large multicentre cohort of patients with T1 high-grade/Grade 3 bladder cancer treated with bacille Calmette–Guérin
Γλώσσες Τεκμηρίου:
Αγγλικά
Περίληψη:
Objectives: To determine if a re-transurethral resection (TUR), in the presence or absence of muscle at the first TUR in patients with T1-high grade (HG)/Grade 3 (G3) bladder cancer, makes a difference in recurrence, progression, cancer specific (CSS) and overall survival (OS). Patients and methods: In a large retrospective multicentre cohort of 2451 patients with T1-HG/G3 initially treated with bacille Calmette–Guérin, 935 (38%) had a re-TUR. According to the presence or absence of muscle in the specimen of the primary TUR, patients were divided in four groups: group 1 (no muscle, no re-TUR), group 2 (no muscle, re-TUR), group 3 (muscle, no re-TUR) and group 4 (muscle, re-TUR). Clinical outcomes were compared across the four groups. Results: Re-TUR had a positive impact on recurrence, progression, CSS and OS only if muscle was not present in the primary TUR specimen. Adjusting for the most important prognostic factors, re-TUR in the absence of muscle had a borderline significant effect on time to recurrence [hazard ratio (HR) 0.67, P = 0.08], progression (HR 0.46, P = 0.06), CSS (HR 0.31, P = 0.07) and OS (HR 0.48, P = 0.05). Re-TUR in the presence of muscle in the primary TUR specimen did not improve the outcome for any of the endpoints. Conclusions: Our retrospective analysis suggests that re-TUR may not be necessary in patients with T1-HG/G3, if muscle is present in the specimen of the primary TUR. © 2015 The Authors BJU International © 2015 BJU International Published by John Wiley & Sons Ltd
Συγγραφείς:
Gontero, P.
Sylvester, R.
Pisano, F.
Joniau, S.
Oderda, M.
Serretta, V.
Larré, S.
Di Stasi, S.
Van Rhijn, B.
Witjes, A.J.
Grotenhuis, A.J.
Colombo, R.
Briganti, A.
Babjuk, M.
Soukup, V.
Malmström, P.-U.
Irani, J.
Malats, N.
Baniel, J.
Mano, R.
Cai, T.
Cha, E.K.
Ardelt, P.
Vakarakis, J.
Bartoletti, R.
Dalbagni, G.
Shariat, S.F.
Xylinas, E.
Karnes, R.J.
Palou, J.
Περιοδικό:
BJU international (Papier)
Εκδότης:
Wiley-Blackwell Publishing Ltd
Λέξεις-κλειδιά:
BCG vaccine, adult; aged; Article; bladder cancer; cancer grading; cancer growth; cancer prognosis; cancer recurrence; cancer specific survival; cohort analysis; controlled clinical trial; controlled study; detrusor muscle; female; human; major clinical study; male; multicenter study; overall survival; priority journal; retrospective study; transurethral resection; treatment outcome
