Factores de riesgo de enfermedad residual en la re-RTU en una gran cohorte de pacientes con enfermedad T1G3 Journal Article
| Authors: | Pisano, F.; Gontero, P.; Sylvester, R.; Joniau, S.; Serretta, V.; Larré, S.; Di Stasi, S.; van Rhijn, B.; Witjes, A.; 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.; Ardelt, P.; Varkarakis, J.; Bartoletti, R.; Dalbagni, G.; Shariat, S. F.; Xylinas, E.; Karnes, R. J.; Palou, J. |
| Article Title: | Factores de riesgo de enfermedad residual en la re-RTU en una gran cohorte de pacientes con enfermedad T1G3 |
| Abstract: | Introduction and objectives: The goals of transurethral resection of a bladder tumor (TUR) are to completely resect the lesions and to make a correct diagnosis in order to adequately stage the patient. It is well known that the presence of detrusor muscle in the specimen is a prerequisite to minimize the risk of under staging. Persistent disease after resection of bladder tumors is not uncommon and is the reason why the European Guidelines recommended a re-TUR for all T1 tumors. It was recently published that when there is muscle in the specimen, re-TUR does not influence progression or cancer specific survival. We present here the patient and tumor factors that may influence the presence of residual disease at re-TUR. Material and methods: In our retrospective cohort of 2451 primary T1G3 patients initially treated with BCG, pathology results for 934 patients (38.1%) who underwent re-TUR are available. 74% had multifocal tumors, 20% of tumors were more than 3 cm in diameter and 26% had concomitant CIS. In this subgroup of patients who underwent re-TUR, there was no residual disease in 267 patients (29%) and residual disease in 667 patients (71%): Ta in 378 (40%) and T1 in 289 (31%) patients. Age, gender, tumor status (primary/recurrent), previous intravesical therapy, tumor size, tumor multi-focality, presence of concomitant CIS, and muscle in the specimen were analyzed in order to evaluate risk factors of residual disease at re-TUR, both in univariate analyses and multivariate logistic regressions. Results: The following were not risk factors for residual disease: age, gender, tumor status and previous intravesical chemotherapy. The following were univariate risk factors for presence of residual disease: no muscle in TUR, multiple tumors, tumors > 3 cm, and presence of concomitant CIS. Due to the correlation between tumor multi-focality and tumor size, the multivariate model retained either the number of tumors or the tumor diameter (but not both), p < 0.001. The presence of muscle in the specimen was no longer significant, while the presence of CIS only remained significant in the model with tumor size, p < 0.001. Conclusions: The most significant factors for a higher risk of residual disease at re-TUR in T1G3 patients are multifocal tumors and tumors more than 3 cm. Patients with concomitant CIS and those without muscle in the specimen also have a higher risk of residual disease. © 2021 AEU |
| Keywords: | recurrence; progression; residual disease; non-muscle invasive bladder cancer; re-transurethral resection of the bladder |
| Journal Title: | Actas Urológicas Españolas |
| Volume: | 45 |
| Issue: | 6 |
| ISSN: | 0210-4806 |
| Publisher: | Elsevier Inc. |
| Date Published: | 2021-07-01 |
| Start Page: | 473 |
| End Page: | 478 |
| Language: | English; Spanish |
| DOI: | 10.1016/j.acuro.2020.08.016 |
| PROVIDER: | scopus |
| PUBMED: | 34147426 |
| DOI/URL: | |
| Notes: | Article -- "Risk factors for residual disease at re-TUR in a large cohort of T1G3 patients" -- Export Date: 1 July 2021 -- Source: Scopus |
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