PURPOSE: High-grade (HG) stage pT1 bladder cancers have the highest recurrence and progression rates of all non-muscle-invasive bladder cancers. Some prognostic factors for recurrence and progression have been identified: multifocal HG pT1, concomitant carcinome in situ, tumor diameter >3 cm, infiltration of the deep lamina propria, and persistence of pT1 tumor on a second transurethral resection of the bladder. The objective of this study was to determine whether the presence of lymphovascular invasion (LVI) is also a prognostic factor that must be taken into account. MATERIALS AND METHODS: This retrospective study was performed with 108 patients with HG stage pT1 bladder cancer: 89 patients were treated conservatively (transurethral resection of the bladder plus bacille Calmette-Guérin therapy), and 19 patients underwent early cystectomy. The mean (SD) follow-up was 47.8 ± 41.2 months. Classic prognostic factors and LVI were analyzed in terms of overall survival, specific survival, recurrence-free survival, and progression-free survival. RESULTS: Thirty-six percent of patients had LVI on the chips of the first transurethral resection of the bladder. Five-year overall survival and specific survival were 40% and 75%, respectively. Multivariate analysis of risk factors showed a significant reduction of overall survival in the presence of LVI (P = .007). The presence of LVI was also a factor of poor prognosis in the case of delayed cystectomy (P = .010) but not in the case of early cystectomy. CONCLUSIONS: Identification of LVI on the first resection of a HG stage pT1 bladder cancer is a significant prognostic factor for overall survival.
PURPOSE: High-grade (HG) stage pT1bladder cancers have the highest recurrence and progression rates of all non-muscle-invasive bladder cancers. Some prognostic factors for recurrence and progression have been identified: multifocal HG pT1, concomitant carcinome in situ, tumor diameter >3 cm, infiltration of the deep lamina propria, and persistence of pT1tumor on a second transurethral resection of the bladder. The objective of this study was to determine whether the presence of lymphovascular invasion (LVI) is also a prognostic factor that must be taken into account. MATERIALS AND METHODS: This retrospective study was performed with 108 patients with HG stage pT1bladder cancer: 89 patients were treated conservatively (transurethral resection of the bladder plus bacille Calmette-Guérin therapy), and 19 patients underwent early cystectomy. The mean (SD) follow-up was 47.8 ± 41.2 months. Classic prognostic factors and LVI were analyzed in terms of overall survival, specific survival, recurrence-free survival, and progression-free survival. RESULTS: Thirty-six percent of patients had LVI on the chips of the first transurethral resection of the bladder. Five-year overall survival and specific survival were 40% and 75%, respectively. Multivariate analysis of risk factors showed a significant reduction of overall survival in the presence of LVI (P = .007). The presence of LVI was also a factor of poor prognosis in the case of delayed cystectomy (P = .010) but not in the case of early cystectomy. CONCLUSIONS: Identification of LVI on the first resection of a HG stage pT1bladder cancer is a significant prognostic factor for overall survival.
Authors: Friedrich-Carl von Rundstedt; Douglas A Mata; Susan Groshen; John P Stein; Donald G Skinner; Walter M Stadler; Richard J Cote; Oleksandr N Kryvenko; Guilherme Godoy; Seth P Lerner Journal: BJU Int Date: 2015-03-25 Impact factor: 5.588
Authors: Kamran Zargar-Shoshtari; Homayoun Zargar; Colin P Dinney; Cesar E Ercole; Pranav Sharma; Evan Kovac; Petros D Grivas; Andrew J Stephenson; Jay B Shah; Peter C Black; Philippe E Spiess Journal: World J Urol Date: 2015-08-19 Impact factor: 4.226