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.

Autor: Gontero P; Urology Clinic, Città della Salute e della Scienza di Torino, University of Studies of Turin, Turin, Italy., Sylvester R; Formerly Department of Biostatistics, EORTC Headquarters, Brussels, Belgium., Pisano F; Urology Clinic, Città della Salute e della Scienza di Torino, University of Studies of Turin, Turin, Italy., Joniau S; Oncologic and Reconstructive Urology, Department of Urology, University Hospitals Leuven, Leuven, Belgium., Oderda M; Urology Clinic, Città della Salute e della Scienza di Torino, University of Studies of Turin, Turin, Italy., Serretta V; Department of Surgical, Oncological and Stomatological Sciences, University of Palermo, Palermo, Italy., Larré S; Department of Surgical Science, John Radcliffe Hospital, University of Oxford, Oxford, UK., Di Stasi S; Policlinico Tor Vergata-University of Rome, Rome, Italy., Van Rhijn B; Department of Urology, Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands., Witjes AJ; Department of Urology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands., Grotenhuis AJ; Department of Urology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands., Colombo R; Dipartimento di Urologia, Università Vita-Salute. Ospedale S. Raffaele, Milan, Italy., Briganti A; Dipartimento di Urologia, Università Vita-Salute. Ospedale S. Raffaele, Milan, Italy., Babjuk M; Department of Urology, Motol Hospital, University of Praha, Praha, Czech Republic., Soukup V; Department of Urology, Motol Hospital, University of Praha, Praha, Czech Republic., Malmström PU; Department of Urology, Academic Hospital, Uppsala University, Uppsala, Sweden., Irani J; Department of Urology, Centre Hospitalier Universitaire La Milétrie, University of Poitiers, Poitiers, France., Malats N; Genetic and Molecular Epidemiology Group, Spanish National Cancer Research Centre (CNIO), Madrid, Spain., Baniel J; Department of Urology, Rabin Medical Centre, Tel Aviv, Israel., Mano R; Department of Urology, Rabin Medical Centre, Tel Aviv, Israel., Cai T; Department of Urology, Santa Chiara Hospital, Trento, Italy., Cha EK; Department of Urology, Weill Medical College of Cornell University in New York City, New York, NY, USA., Ardelt P; Facharzt fur Urologie, Abteilung fur Urologie. Chirurgische Universitats klinik, Freiburg, Germany., Vakarakis J; Department of Urology, Sismanoglio Hospital, University of Athens, Athens, Greece., Bartoletti R; Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy., Dalbagni G; Department of Urology, Memorial Sloan Kettering Cancer Center, New York, NY, USA., Shariat SF; Department of Urology, Weill Medical College of Cornell University in New York City, New York, NY, USA., Xylinas E; Department of Urology, Weill Medical College of Cornell University in New York City, New York, NY, USA., Karnes RJ; Department of Urology, Mayo Clinic, Rochester, MN, USA., Palou J; Department of Urology, Fundacio Puigvert, University of Barcelona, Barcelona, Spain.
Jazyk: angličtina
Zdroj: BJU international [BJU Int] 2016 Jul; Vol. 118 (1), pp. 44-52. Date of Electronic Publication: 2015 Nov 06.
DOI: 10.1111/bju.13354
Abstrakt: 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.)
Databáze: MEDLINE
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