Predictive clinico-pathological factors to identify BCG, unresponsive patients, after re-resection for T1 high grade non-muscle invasive bladder cancer.
Обработка статьи · этапы, ошибки и управление
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Ferro Matteo, Barone Biagio, Crocetto Felice, Lucarelli Giuseppe, Busetto Gian Maria, Del Giudice Francesco, Maggi Martina, Crocerossa Fabio, Cantiello Francesco, Damiano Rocco, Borghesi Marco, Bove Pier Luigi, Papalia Rocco, Mari Andrea, Luzzago Stefano, Soria Francesco, Marchioni Michele, La Civita Evelina, Terracciano Daniela, Mistretta Francesco Alessandro, Piccinelli Mattia, Marmiroli Andrea, Russo Giorgio Ivan, Schips Luigi, Hurle Rodolfo, Contieri Roberto, Perdonà Sisto, Del Prete Paola, Mirone Vincenzo, Tataru Octavian Sabin, Musi Gennaro, Montanari Emanuele, de Cobelli Ottavio, Vartolomei Mihai Dorin
Аннотация
MATERIALS AND METHODS: Patients with non-muscle invasive bladder cancer from 13 hospitals and academic institutions were identified and treated, from January 1, 2002, until December 31, 2012, with TURB and a subsequent re-TURB for restaging before receiving BCG. Follow-up was performed with urine cytology and cystoscopy every 3 months for 1 year and, successively every 6 months. Univariate and multivariate Cox regression models addressed the response to BCG therapy. Kaplan-Meier overall survival (OS) and cancer-specific survival (CSS) estimates were determined for BCG responsive vs. BCG unresponsive patients.
RESULTS: A total of 1,228 patients with non-muscle invasive bladder cancer were enrolled. Of 257 (20.9%) patients were BCG unresponsive. Independent predictive factors for response to BCG were: multifocality (HR: 1.4; 95% CI 1.05-1.86; P = 0.019), lymphovascular invasion (HR: 1.75; 95% CI 1.22-2.49; P = 0.002) and high-grade on re-TURB (HR: 1.39; 95% CI 1.02-1.91; P = 0.037). Overall survival was significantly reduced in BCG-unresponsive patients compared to BCG-responsive patients at 5 years (82.9% vs. 92.4%, P < 0.0001) and at 10 years (44.2% vs. 74.4%, P < 0.0001). Similarly, cancer-specific survival was reduced in BCG-unresponsive patients at 5 years (90.6% vs. 97.3%, P < 0.0001) and at 10 years (72.3% vs. 87.2%, P < 0.0001).
CONCLUSION: Multifocality, lymphovascular invasion, and high-grade on re-TURB were independent predictors for response to BCG treatment. BCG-unresponsive patients reported worse oncological outcomes.