BACKGROUND: The treatment of high-risk non-muscle-invasive bladder cancer (BCa) is problematic given the variable natural history of the disease. Few reports have compared outcomes for primary high-risk tumours with those that develop following previous BCas (relapses). The latter represent a self-selected cohort, having failed previous treatments. OBJECTIVE: To compare outcomes in patients with primary, progressive, and recurrent high-risk non-muscle-invasive BCa. DESIGN, SETTING, AND PARTICIPANTS: We identified all patients with primary and relapsing high-risk BCa tumours at our institution since 1994. Relapses were divided into progressive (previous low- or intermediate-risk disease) and recurrent (previous high-risk disease) cancers. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: Relationships with outcome analysed using multivariable Cox regression and log-rank analysis. RESULTS AND LIMITATIONS: We identified 699 primary, 110 progressive, and 494 recurrent high-risk BCa tumours in 809 patients (average follow-up: 59 mo [interquartile range: 6-190]). Muscle invasion occurred most commonly in recurrent (23%) tumours, when compared to progressive (20%) and primary (14.6%) cohorts (log rank p<0.001). Disease-specific mortality (DSM) occurred more frequently in patients with recurrent (25.5%) and progressive (24.6%) tumours compared to primary disease (19.2%; log rank p=0.006). Other-cause mortality was similar in all groups (log rank p=0.57), and overall mortality was highest in the progressive cohort (62%) compared with the recurrent (58%) and primary groups (54%; log rank p<0.001). In multivariable analysis, progression and DSM were predicted by tumour grouping (hazard ratio [HR]: >1.15; p<0.026), stage (HR: >1.30; p<0.001), and patient age and sex (HR: >1.03; p<0.037). Carcinoma in situ was only predictive of outcome in primary tumors. Limitations include retrospective design and limited details regarding bacillus Camille-Guérin use. CONCLUSIONS: Patients with relapsing, high-risk, BCa tumors have higher progression, DSM, and overall mortality rates than those with primary cancers. The use of bladder-sparing strategies in these patients should approached cautiously. Carcinoma in situ has little predicative role in relapsing, high-risk, BCa tumors. Crown
BACKGROUND: The treatment of high-risk non-muscle-invasive bladder cancer (BCa) is problematic given the variable natural history of the disease. Few reports have compared outcomes for primary high-risk tumours with those that develop following previous BCas (relapses). The latter represent a self-selected cohort, having failed previous treatments. OBJECTIVE: To compare outcomes in patients with primary, progressive, and recurrent high-risk non-muscle-invasive BCa. DESIGN, SETTING, AND PARTICIPANTS: We identified all patients with primary and relapsing high-risk BCa tumours at our institution since 1994. Relapses were divided into progressive (previous low- or intermediate-risk disease) and recurrent (previous high-risk disease) cancers. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: Relationships with outcome analysed using multivariable Cox regression and log-rank analysis. RESULTS AND LIMITATIONS: We identified 699 primary, 110 progressive, and 494 recurrent high-risk BCa tumours in 809 patients (average follow-up: 59 mo [interquartile range: 6-190]). Muscle invasion occurred most commonly in recurrent (23%) tumours, when compared to progressive (20%) and primary (14.6%) cohorts (log rank p<0.001). Disease-specific mortality (DSM) occurred more frequently in patients with recurrent (25.5%) and progressive (24.6%) tumours compared to primary disease (19.2%; log rank p=0.006). Other-cause mortality was similar in all groups (log rank p=0.57), and overall mortality was highest in the progressive cohort (62%) compared with the recurrent (58%) and primary groups (54%; log rank p<0.001). In multivariable analysis, progression and DSM were predicted by tumour grouping (hazard ratio [HR]: >1.15; p<0.026), stage (HR: >1.30; p<0.001), and patient age and sex (HR: >1.03; p<0.037). Carcinoma in situ was only predictive of outcome in primary tumors. Limitations include retrospective design and limited details regarding bacillus Camille-Guérin use. CONCLUSIONS:Patients with relapsing, high-risk, BCa tumors have higher progression, DSM, and overall mortality rates than those with primary cancers. The use of bladder-sparing strategies in these patients should approached cautiously. Carcinoma in situ has little predicative role in relapsing, high-risk, BCa tumors. Crown
Authors: K E Tipirneni; E L Rosenthal; L S Moore; A D Haskins; N Udayakumar; A H Jani; W R Carroll; A B Morlandt; M Bogyo; J Rao; Jason M Warram Journal: Mol Imaging Biol Date: 2017-10 Impact factor: 3.488
Authors: Nico C Grossmann; Pawel Rajwa; Fahad Quhal; Frederik König; Hadi Mostafaei; Ekaterina Laukhtina; Keiichiro Mori; Satoshi Katayama; Reza Sari Motlagh; Christian D Fankhauser; Agostino Mattei; Marco Moschini; Piotr Chlosta; Bas W G van Rhijn; Jeremy Y C Teoh; Eva Compérat; Marek Babjuk; Mohammad Abufaraj; Pierre I Karakiewicz; Shahrokh F Shariat; Benjamin Pradere Journal: Eur Urol Open Sci Date: 2022-04-01
Authors: Jamie B Oughton; Heather Poad; Maureen Twiddy; Michelle Collinson; Victoria Hiley; Kathryn Gordon; Mark Johnson; Sunjay Jain; Aidan P Noon; Rohit Chahal; Matt Simms; Mohantha Dooldeniya; Phillip Koenig; Louise Goodwin; Julia M Brown; James W F Catto Journal: BMJ Open Date: 2017-08-11 Impact factor: 2.692
Authors: Valeria Panebianco; Yoshifumi Narumi; Ersan Altun; Bernard H Bochner; Jason A Efstathiou; Shaista Hafeez; Robert Huddart; Steve Kennish; Seth Lerner; Rodolfo Montironi; Valdair F Muglia; Georg Salomon; Stephen Thomas; Hebert Alberto Vargas; J Alfred Witjes; Mitsuru Takeuchi; Jelle Barentsz; James W F Catto Journal: Eur Urol Date: 2018-05-10 Impact factor: 20.096
Authors: Lampros P Mitrakas; Ioannis V Zachos; Vassileios P Tzortzis; Stavros A Gravas; Erasmia C Rouka; Konstantinos I Dimitropoulos; Gerasimos P Vandoros; Anastasios D Karatzas; Michael D Melekos; Athanasios G Papavassiliou Journal: Cancer Res Treat Date: 2014-09-11 Impact factor: 4.679