Oncological outcome of primary versus secondary muscle-invasive bladder cancer is comparable after radical cystectomy
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Oncological outcome of primary versus secondary muscle-invasive bladder cancer is comparable after radical cystectomy. / Aziz, A; Gierth, M; Fritsche, H M; May, M; Otto, W; Denzinger, S; Wieland, W F; Merseburger, A; Riedmiller, H; Kocot, A; Burger, M.
in: UROL INT, Jahrgang 91, Nr. 1, 2013, S. 97-102.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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TY - JOUR
T1 - Oncological outcome of primary versus secondary muscle-invasive bladder cancer is comparable after radical cystectomy
AU - Aziz, A
AU - Gierth, M
AU - Fritsche, H M
AU - May, M
AU - Otto, W
AU - Denzinger, S
AU - Wieland, W F
AU - Merseburger, A
AU - Riedmiller, H
AU - Kocot, A
AU - Burger, M
N1 - Copyright © 2013 S. Karger AG, Basel.
PY - 2013
Y1 - 2013
N2 - BACKGROUND: High-risk non-muscle-invasive bladder cancer (NMIBC) progressing to muscle-invasive bladder cancer (MIBC) is associated with adverse tumour biology. It is unclear, however, whether outcome of NMIBC progressing to MIBC is adverse compared to primary MIBC and whether NMIBC of higher risk of progression to MIBC is adverse compared to NMIBC of lower risk.OBJECTIVE: Our objective was to assess cancer-specific survival (CSS) following radical cystectomy (RC) for primary MIBC and for NMIBC progressing to MIBC in dependence of EORTC risk score.MATERIALS AND METHODS: Clinical and histopathological characteristics and CSS of 150 patients were assessed. Secondary MIBCs were stratified by EORTC risk score at the last transurethral resection of bladder tumour for NMIBC.RESULTS: CSS did not differ significantly between primary and secondary MIBC (p = 0.521). Secondary MIBC with high EORTC score had significantly shorter CSS compared to secondary MIBC with intermediate EORTC score (p = 0.029). In multivariable analysis, pathological tumour stage (HR = 3.77; p = 0.020) and lymph node stage (HR = 2.34; p = 0.022) were significantly correlated with CSS.CONCLUSION: While the outcome of secondary MIBC is not generally adverse compared to primary MIBC, the EORTC risk score not only reflects high risk of progression of NMIBC to MIBC, but also worse outcome following RC for secondary MIBC. Timely RC should thus be debated in high-risk NMIBC.
AB - BACKGROUND: High-risk non-muscle-invasive bladder cancer (NMIBC) progressing to muscle-invasive bladder cancer (MIBC) is associated with adverse tumour biology. It is unclear, however, whether outcome of NMIBC progressing to MIBC is adverse compared to primary MIBC and whether NMIBC of higher risk of progression to MIBC is adverse compared to NMIBC of lower risk.OBJECTIVE: Our objective was to assess cancer-specific survival (CSS) following radical cystectomy (RC) for primary MIBC and for NMIBC progressing to MIBC in dependence of EORTC risk score.MATERIALS AND METHODS: Clinical and histopathological characteristics and CSS of 150 patients were assessed. Secondary MIBCs were stratified by EORTC risk score at the last transurethral resection of bladder tumour for NMIBC.RESULTS: CSS did not differ significantly between primary and secondary MIBC (p = 0.521). Secondary MIBC with high EORTC score had significantly shorter CSS compared to secondary MIBC with intermediate EORTC score (p = 0.029). In multivariable analysis, pathological tumour stage (HR = 3.77; p = 0.020) and lymph node stage (HR = 2.34; p = 0.022) were significantly correlated with CSS.CONCLUSION: While the outcome of secondary MIBC is not generally adverse compared to primary MIBC, the EORTC risk score not only reflects high risk of progression of NMIBC to MIBC, but also worse outcome following RC for secondary MIBC. Timely RC should thus be debated in high-risk NMIBC.
KW - Aged
KW - Cystectomy
KW - Disease Progression
KW - Female
KW - Humans
KW - Male
KW - Middle Aged
KW - Multivariate Analysis
KW - Muscles
KW - Neoplasm Invasiveness
KW - Probability
KW - Proportional Hazards Models
KW - Risk
KW - Time Factors
KW - Treatment Outcome
KW - Urinary Bladder Neoplasms
KW - Journal Article
U2 - 10.1159/000350232
DO - 10.1159/000350232
M3 - SCORING: Journal article
C2 - 23751372
VL - 91
SP - 97
EP - 102
JO - UROL INT
JF - UROL INT
SN - 0042-1138
IS - 1
ER -