Prognostic Factors for Recurrence and Progression in Korean Non-Muscle-Invasive Bladder Cancer Patients: A Retrospective, Multi-Institutional Study.

Autor:	Kim HS; Department of Urology, Dongguk University Ilsan Medical Center, Goyang, Korea., Ku JH; Department of Urology, Seoul National University College of Medicine, Seoul, Korea., Kim SJ; Department of Urology, Ajou University College of Medicine, Suwon, Korea., Hong SJ; Department of Urology, Yonsei University College of Medicine, Seoul, Korea., Hong SH; Department of Urology, The Catholic University College of Medicine, Seoul, Korea., Kim HS; Department of Urology, Konkuk University College of Medicine, Chungju, Korea., Kwon TG; Department of Urology, Kyungpook National University College of Medicine, Daegu, Korea., Cho JS; Department of Urology, Hallym University College of Medicine, Chuncheon, Korea., Jeon SS; Department of Urology, Samsung Medical Center, Sungkyunkwan University College of Medicine, Seoul, Korea., Joo KJ; Department of Urology, Kangbuk Samsung Hospital, Sungkyunkwan University College of Medicine, Seoul, Korea., Ahn HJ; Department of Urology, Asan Medical Center, Ulsan University College of Medicine, Seoul, Korea., Park HS; Department of Urology, Korea University College of Medicine, Seoul, Korea., Seong do H; Department of Urology, Inha University College of Medicine, Incheon, Korea., Kwon DD; Department of Urology, Chonnam National University College of Medicine, Gwangju, Korea., Kim HJ; Department of Urology, Chonbuk National University College of Medicine, Jeonju, Korea., Lim JS; Department of Urology, Chungnam National University College of Medicine, Daejeon, Korea., Lee HL; Department of Urology, Kyung Hee University School of Medicine, Seoul, Korea. hllee61@hanmail.net.
Jazyk:	angličtina
Zdroj:	Yonsei medical journal [Yonsei Med J] 2016 Jul; Vol. 57 (4), pp. 855-64.
DOI:	10.3349/ymj.2016.57.4.855
Abstrakt:	Purpose: To identify the prognostic factors related to tumor recurrence and progression in Korean patients with non-muscle-invasive bladder cancer (NMIBC). Materials and Methods: Data were collected and analyzed for 2412 NMIBC patients from 15 centers who were initially diagnosed after transurethral resection of bladder tumor (TURBT) from January 2006 to December 2010. Using univariable and multivariable Cox proportional hazards models, the prognostic value of each variable was evaluated for the time to first recurrence and progression. Results: With a median follow-up duration of 37 months, 866 patients (35.9%) experienced recurrence, and 137 (5.7%) experienced progression. Patients with recurrence had a median time to the first recurrence of 10 months. Multivariable analysis conducted in all patients revealed that preoperative positive urine cytology (PUC) was independently associated with worse recurrence-free survival [RFS; hazard ratio (HR) 1.56; p<0.001], and progression-free survival (PFS; HR 1.56; p=0.037). In particular, on multivariable analysis conducted for the high-risk group (T1 tumor/high-grade Ta tumor/carcinoma in situ), preoperative PUC was an independent predictor of worse RFS (HR 1.73; p<0.001) and PFS (HR 1.96; p=0.006). On multivariable analysis in patients with T1 high-grade (T1HG) cancer (n=684), better RFS (HR 0.75; p=0.033) and PFS (HR 0.33; p<0.001) were observed in association with the administration of intravesical Bacillus Calmette-Guérin (BCG) induction therapy. Conclusion: A preoperative PUC result may adversely affect RFS and PFS, particularly in high-risk NMIBC patients. Of particular note, intravesical BCG induction therapy should be administered as an adjunct to TURBT in order to improve RFS and PFS in patients with T1HG cancer.
Databáze:	MEDLINE
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