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Bishr M, Lattouf JB, Latour M, et al. Tumour stage on re-staging transurethral resection predicts recurrence and progression-free survival of patients with high-risk non-muscle invasive bladder cancer. Can Urol Assoc J. 2014;8(5):E306-10doi: 10.5489/cuaj.1514.
Bishr, M., Lattouf, J. B., Latour, M., & Saad, F. (2014). Tumour stage on re-staging transurethral resection predicts recurrence and progression-free survival of patients with high-risk non-muscle invasive bladder cancer. Canadian Urological Association journal = Journal de l'Association des urologues du Canada, 8(5), E306-10. https://doi.org/10.5489/cuaj.1514
Bishr, Mohamed, et al. "Tumour stage on re-staging transurethral resection predicts recurrence and progression-free survival of patients with high-risk non-muscle invasive bladder cancer." Canadian Urological Association journal = Journal de l'Association des urologues du Canada vol. 8,5 (2014): E306-10. doi: https://doi.org/10.5489/cuaj.1514
Bishr M, Lattouf JB, Latour M, Saad F. Tumour stage on re-staging transurethral resection predicts recurrence and progression-free survival of patients with high-risk non-muscle invasive bladder cancer. Can Urol Assoc J. 2014 May;8(5):E306-10. doi: 10.5489/cuaj.1514. PMID: 24940455; PMCID: PMC4039592.
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Can Urol Assoc J. 2014 May;8(5):E306-10. doi: 10.5489/cuaj.1514.

Tumour stage on re-staging transurethral resection predicts recurrence and progression-free survival of patients with high-risk non-muscle invasive bladder cancer.

Canadian Urological Association journal = Journal de l'Association des urologues du Canada

Mohamed Bishr, Jean-Baptiste Lattouf, Mathieu Latour, Fred Saad

Affiliations

  1. Department of Urology, Centre hospitalier de l'Université de Montréal, Montreal, QC;
  2. Department of Pathology, Centre hospitalier de l'Université de Montréal, Montreal, QC.

PMID: 24940455 PMCID: PMC4039592 DOI: 10.5489/cuaj.1514

Abstract

INTRODUCTION: To identify patients who should be considered for early radical cystectomy, we evaluated the clinical and pathological variables affecting the outcome of patients with high-risk non-muscle invasive bladder cancer (NMIBC) who underwent re-staging transurethral resection (re-TUR).

METHODS: We reviewed the clinical data of 453 patients treated for urothelial carcinoma between 2006 and 2010. In total, 94 patients underwent re-TUR after their initial TUR. Of these, 72 were not upstaged to muscle invasive disease and were therefore included in our study.

RESULTS: On re-TUR, 31 patients had no residual tumour (T0) and 41 patients had residual NMIBC. A statistically significant difference was noted between patients with pT0 and patients with residual NMIBC on re-TUR in regard to tumour recurrence and progression (39% vs. 83%, p < 0.001) (6% vs. 34%, p = 0.005), respectively. On multivariate analysis, tumour stage on re-TUR and the regimen of intravesical bacillus Calmette-Guérin (BCG) therapy (induction vs. maintenance) remained independent predicting factors for recurrence-free survival (RFS) (p = 0.001, hazard ratio [HR]: 1.77), (p < 0.001 HR: 0.16) and progression-free survival (PFS) (p = 0.014, HR: 2.11), (p = 0.008, HR: 0.097), respectively.

CONCLUSIONS: The presence of T0 on re-TUR is associated with better RFS and PFS and could be a predictive factor for candidates for conservative management. Patients with persistent NMIBC on re-TUR require close follow-up and, in some cases, could be considered for early cystectomy. Maintenance intravesical BCG therapy can improve RFS and PFS in patients with high-risk NMIBC. This study is limited by its retrospective nature and the relatively small number of patients in the cohort.

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