Long-term cancer-specific outcomes of TaG1 urothelial carcinoma of the bladder
Standard
Long-term cancer-specific outcomes of TaG1 urothelial carcinoma of the bladder. / Rieken, Malte; Xylinas, Evanguelos; Kluth, Luis; Crivelli, Joseph J; Chrystal, James; Faison, Talia; Lotan, Yair; Karakiewicz, Pierre I; Holmäng, Sten; Babjuk, Marek; Fajkovic, Harun; Seitz, Christian; Klatte, Tobias; Pycha, Armin; Bachmann, Alexander; Scherr, Douglas S; Shariat, Shahrokh F.
in: EUR UROL, Jahrgang 65, Nr. 1, 01.01.2014, S. 201-209.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
Harvard
APA
Vancouver
Bibtex
}
RIS
TY - JOUR
T1 - Long-term cancer-specific outcomes of TaG1 urothelial carcinoma of the bladder
AU - Rieken, Malte
AU - Xylinas, Evanguelos
AU - Kluth, Luis
AU - Crivelli, Joseph J
AU - Chrystal, James
AU - Faison, Talia
AU - Lotan, Yair
AU - Karakiewicz, Pierre I
AU - Holmäng, Sten
AU - Babjuk, Marek
AU - Fajkovic, Harun
AU - Seitz, Christian
AU - Klatte, Tobias
AU - Pycha, Armin
AU - Bachmann, Alexander
AU - Scherr, Douglas S
AU - Shariat, Shahrokh F
N1 - Copyright © 2013 European Association of Urology. Published by Elsevier B.V. All rights reserved.
PY - 2014/1/1
Y1 - 2014/1/1
N2 - BACKGROUND: Few studies have investigated the natural history of TaG1 urothelial carcinoma of the bladder (UCB).OBJECTIVE: To assess the long-term outcomes of patients with TaG1 UCB and the impact of immediate postoperative instillation of chemotherapy (IPIC).DESIGN, SETTING, AND PARTICIPANTS: A retrospective analysis of 1447 patients with TaG1 UCB treated between 1996 and 2007 at eight centers. Median follow-up was 67.2 mo (interquartile range: 67.9). Patients were stratified into three European Association of Urology (EAU) guidelines risk categories; high-risk patients (n=11) were excluded.INTERVENTION: Transurethral resection of the bladder with or without IPIC.OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: Univariable and multivariable Cox regression models addressed factors associated with disease recurrence, disease progression, death of disease, and any-cause death.RESULTS AND LIMITATIONS: Of the 1436 patients, 601 (41.9%) and 835 (58.1%) were assigned to low- and intermediate-risk categories, respectively. The actuarial estimate of 5-yr recurrence-free survival was 56% (standard error: ± 1). Advancing age (p=0.04), tumor >3 cm (p=0.001), multiple tumors (p<0.001), and recurrent tumors (p<0.001) were independently associated with increased risk of disease recurrence, whereas IPIC was associated with decreased risk (p=0.001). The actuarial estimate of 5-yr progression-free survival was 95% ± 1. Advancing age (p<0.001) and multiple tumors (p=0.01) were independent risk factors for disease progression. Five-year cancer-specific survival was 98% ± 1. Advancing age (p=0.001) and previous recurrence (p=0.04) were associated with increased risk, whereas female gender (p=0.02) was associated with decreased risk of cancer-specific mortality. Compared with low-risk patients, intermediate-risk patients were at significantly higher risk of disease recurrence, disease progression, and cancer-specific mortality (all p<0.01). Limitations include the retrospective design of the study and the lack of a central pathology review.CONCLUSIONS: TaG1 UCB patients experience heterogeneous risks of disease recurrence. We validated the EAU guidelines risk stratification in TaG1 UCB patients. IPIC was associated with a reduced risk of disease recurrence in patients with low- and intermediate-risk TaG1 UCB.
AB - BACKGROUND: Few studies have investigated the natural history of TaG1 urothelial carcinoma of the bladder (UCB).OBJECTIVE: To assess the long-term outcomes of patients with TaG1 UCB and the impact of immediate postoperative instillation of chemotherapy (IPIC).DESIGN, SETTING, AND PARTICIPANTS: A retrospective analysis of 1447 patients with TaG1 UCB treated between 1996 and 2007 at eight centers. Median follow-up was 67.2 mo (interquartile range: 67.9). Patients were stratified into three European Association of Urology (EAU) guidelines risk categories; high-risk patients (n=11) were excluded.INTERVENTION: Transurethral resection of the bladder with or without IPIC.OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: Univariable and multivariable Cox regression models addressed factors associated with disease recurrence, disease progression, death of disease, and any-cause death.RESULTS AND LIMITATIONS: Of the 1436 patients, 601 (41.9%) and 835 (58.1%) were assigned to low- and intermediate-risk categories, respectively. The actuarial estimate of 5-yr recurrence-free survival was 56% (standard error: ± 1). Advancing age (p=0.04), tumor >3 cm (p=0.001), multiple tumors (p<0.001), and recurrent tumors (p<0.001) were independently associated with increased risk of disease recurrence, whereas IPIC was associated with decreased risk (p=0.001). The actuarial estimate of 5-yr progression-free survival was 95% ± 1. Advancing age (p<0.001) and multiple tumors (p=0.01) were independent risk factors for disease progression. Five-year cancer-specific survival was 98% ± 1. Advancing age (p=0.001) and previous recurrence (p=0.04) were associated with increased risk, whereas female gender (p=0.02) was associated with decreased risk of cancer-specific mortality. Compared with low-risk patients, intermediate-risk patients were at significantly higher risk of disease recurrence, disease progression, and cancer-specific mortality (all p<0.01). Limitations include the retrospective design of the study and the lack of a central pathology review.CONCLUSIONS: TaG1 UCB patients experience heterogeneous risks of disease recurrence. We validated the EAU guidelines risk stratification in TaG1 UCB patients. IPIC was associated with a reduced risk of disease recurrence in patients with low- and intermediate-risk TaG1 UCB.
U2 - 10.1016/j.eururo.2013.08.034
DO - 10.1016/j.eururo.2013.08.034
M3 - SCORING: Journal article
C2 - 23998688
VL - 65
SP - 201
EP - 209
JO - EUR UROL
JF - EUR UROL
SN - 0302-2838
IS - 1
ER -