Conditional analyses of recurrence and progression in patients with TaG1 non-muscle-invasive bladder cancer
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Conditional analyses of recurrence and progression in patients with TaG1 non-muscle-invasive bladder cancer. / von Landenberg, Nicolas; Aziz, Atiqullah; von Rundstedt, Friedrich C; Dobruch, Jakub; Kluth, Luis A; Necchi, Andrea; Noon, Aidan; Rink, Michael; Hendricksen, Kees; Decaestecker, Karel P J; Seiler, Roland; Poyet, Cédric; Fajkovic, Harun; Shariat, Shahrokh F; Xylinas, Evanguelos; Roghmann, Florian; Young Academic Urologists′ Working Group on Urothelial Cancer of the European Association of Urology.
in: UROL ONCOL-SEMIN ORI, Jahrgang 36, Nr. 5, 05.2018, S. 238.e19-238.e27.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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TY - JOUR
T1 - Conditional analyses of recurrence and progression in patients with TaG1 non-muscle-invasive bladder cancer
AU - von Landenberg, Nicolas
AU - Aziz, Atiqullah
AU - von Rundstedt, Friedrich C
AU - Dobruch, Jakub
AU - Kluth, Luis A
AU - Necchi, Andrea
AU - Noon, Aidan
AU - Rink, Michael
AU - Hendricksen, Kees
AU - Decaestecker, Karel P J
AU - Seiler, Roland
AU - Poyet, Cédric
AU - Fajkovic, Harun
AU - Shariat, Shahrokh F
AU - Xylinas, Evanguelos
AU - Roghmann, Florian
AU - Young Academic Urologists′ Working Group on Urothelial Cancer of the European Association of Urology
N1 - Copyright © 2018 Elsevier Inc. All rights reserved.
PY - 2018/5
Y1 - 2018/5
N2 - OBJECTIVE: To determine conditional recurrence-free survival (RFS) and progression-free survival (PFS) and improve decision-making toward surveillance protocols and scheduling. Furthermore, evaluating the evolution of predictors for disease recurrence over time, because TaG1 non-muscle-invasive bladder cancer harbors a risk of disease recurrence and progression.MATERIAL AND METHODS: The retrospective multicenter design study includes 1,245 TaG1 bladder cancer patients with median follow-up of 62.7 (interquartile range: 34.3-91.1) months. Conditional RFS and PFS estimates were calculated using the Kaplan-Meier method. Multivariable Cox regression model was calculated proportional for the prediction of recurrence and progression (covariables: age, tumor size, multiple tumors, prior recurrence, and immediate postoperative instillation of chemotherapy).RESULTS: After 3 months without event, the conditional RFS and PFS (to ≥pT2) rates for 5 additional years without event were 57.5% and 93.4%, respectively. Given a 1-, 2-, 3-, and 5-year survival, the conditional RFS rates for 5 additional years without event improved by +9.8 (67.3%), +5.2 (72.5%), +6.5 (79.0%), +2.0 (81.0%), and +1.0% (82.0%), respectively. In contrast, the 5-year conditional PFS rates were more or less stable with 94.3% after 1 year to 94.1% after 5 years. Multivariable analyses showed decreasing impact of risk parameters on RFS estimates over time. Based on these findings, we suggest a risk stratification to individualize follow-up for intermediate risk TaG1. Main limitation was the retrospective design.CONCLUSIONS: Conditional-survival analyses demonstrates that the patient risk profile changes over time. RFS rates rise with increasing survival whereas PFS rates were stable. The impact of prognostic features decreases over time. Our findings can be used for patient counseling and planning of personalized follow-up.
AB - OBJECTIVE: To determine conditional recurrence-free survival (RFS) and progression-free survival (PFS) and improve decision-making toward surveillance protocols and scheduling. Furthermore, evaluating the evolution of predictors for disease recurrence over time, because TaG1 non-muscle-invasive bladder cancer harbors a risk of disease recurrence and progression.MATERIAL AND METHODS: The retrospective multicenter design study includes 1,245 TaG1 bladder cancer patients with median follow-up of 62.7 (interquartile range: 34.3-91.1) months. Conditional RFS and PFS estimates were calculated using the Kaplan-Meier method. Multivariable Cox regression model was calculated proportional for the prediction of recurrence and progression (covariables: age, tumor size, multiple tumors, prior recurrence, and immediate postoperative instillation of chemotherapy).RESULTS: After 3 months without event, the conditional RFS and PFS (to ≥pT2) rates for 5 additional years without event were 57.5% and 93.4%, respectively. Given a 1-, 2-, 3-, and 5-year survival, the conditional RFS rates for 5 additional years without event improved by +9.8 (67.3%), +5.2 (72.5%), +6.5 (79.0%), +2.0 (81.0%), and +1.0% (82.0%), respectively. In contrast, the 5-year conditional PFS rates were more or less stable with 94.3% after 1 year to 94.1% after 5 years. Multivariable analyses showed decreasing impact of risk parameters on RFS estimates over time. Based on these findings, we suggest a risk stratification to individualize follow-up for intermediate risk TaG1. Main limitation was the retrospective design.CONCLUSIONS: Conditional-survival analyses demonstrates that the patient risk profile changes over time. RFS rates rise with increasing survival whereas PFS rates were stable. The impact of prognostic features decreases over time. Our findings can be used for patient counseling and planning of personalized follow-up.
KW - Aged
KW - Disease Progression
KW - Female
KW - Follow-Up Studies
KW - Humans
KW - Male
KW - Middle Aged
KW - Neoplasm Invasiveness
KW - Neoplasm Recurrence, Local
KW - Neoplasm Staging
KW - Retrospective Studies
KW - Risk Factors
KW - Survival Rate
KW - Urinary Bladder Neoplasms
KW - Journal Article
KW - Multicenter Study
U2 - 10.1016/j.urolonc.2018.01.017
DO - 10.1016/j.urolonc.2018.01.017
M3 - SCORING: Journal article
C2 - 29506940
VL - 36
SP - 238.e19-238.e27
JO - UROL ONCOL-SEMIN ORI
JF - UROL ONCOL-SEMIN ORI
SN - 1078-1439
IS - 5
ER -
