Matthias May1, Hans-Martin Fritsche2, Malte W Vetterlein3, Patrick J Bastian4, Michael Gierth2, Philipp Nuhn5, Atiqullah Aziz3, Margit Fisch3, Christian G Stief6, Markus Hohenfellner7, Manfred P Wirth8, Vladimir Novotny8, Oliver W Hakenberg9, Joachim Noldus10, Christian Gilfrich11, Christian Bolenz12, Maximilian Burger2, Sabine D Brookman-May6. 1. Department of Urology, St. Elisabeth-Hospital Straubing, St. Elisabeth-Straße 23, 94315, Straubing, Germany. matthias.may@klinikum-straubing.de. 2. Department of Urology, Caritas-Hospital St. Josef, University of Regensburg, Regensburg, Germany. 3. Department of Urology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany. 4. Department of Urology, Marien-Hospital Düsseldorf, Düsseldorf, Germany. 5. Department of Urology, University Medical Centre Mannheim, University of Heidelberg, Mannheim, Germany. 6. Department of Urology, Ludwig-Maximilians-University Munich, Munich, Germany. 7. Department of Urology, University of Heidelberg, Heidelberg, Germany. 8. Department of Urology, University Hospital 'Carl Gustav Carus', Dresden University of Technology, Dresden, Germany. 9. Department of Urology, University of Rostock, Rostock, Germany. 10. Department of Urology, Marien-Hospital Herne, Ruhr-University of Bochum, Herne, Germany. 11. Department of Urology, St. Elisabeth-Hospital Straubing, St. Elisabeth-Straße 23, 94315, Straubing, Germany. 12. Department of Urology, University of Ulm, Ulm, Germany.
Abstract
PURPOSE: Results of a retrospective single-institution study recently suggested improved prognostic outcomes in patients undergoing photodynamic diagnosis (PDD)-assisted transurethral resection of bladder tumor (TURBT) prior to radical cystectomy (RC). We sought to validate the prognostic influence of PDD-assisted TURBT on survival after RC by relying on a multi-institutional dataset. METHODS: To provide a homogeneous study population, patients with organ metastasis at the time of RC and/or after neoadjuvant chemotherapy were excluded from analysis, which resulted in overall 549 bladder cancer (BC) patients from 18 centers of the Prospective Multicenter Radical Cystectomy Series 2011 (PROMETRICS 2011). To evaluate the influence of PDD conducted during primary or final TURBT on cancer-specific mortality (CSM) and overall mortality (OM) after RC, bootstrap-corrected multivariate Cox proportional-hazards regression models were applied (median follow-up: 25 months; IQR: 19-30). Sensitivity analyses were performed for both patients with pure urothelial carcinoma and patients undergoing one single TURBT only. RESULTS: In 88 (16.0 %) and 100 (18.2 %) patients, PDD was used in primary and final TURBTs, respectively. In 335 (61.0 %) patients, a single TURBT was performed prior to RC; in 194 patients (35.3 %), TURBT had been performed in a different center. CSM and OM rates at 3 years were 32 and 40 %, respectively. Use of PDD during primary or final TURBT was no independent predictor of CSM or OM. These results were internally valid and were confirmed in sensitivity analyses. CONCLUSIONS: PDD utilization during TURBT prior to RC does not independently impact the prognosis of BC patients after RC.
PURPOSE: Results of a retrospective single-institution study recently suggested improved prognostic outcomes in patients undergoing photodynamic diagnosis (PDD)-assisted transurethral resection of bladder tumor (TURBT) prior to radical cystectomy (RC). We sought to validate the prognostic influence of PDD-assisted TURBT on survival after RC by relying on a multi-institutional dataset. METHODS: To provide a homogeneous study population, patients with organ metastasis at the time of RC and/or after neoadjuvant chemotherapy were excluded from analysis, which resulted in overall 549 bladder cancer (BC) patients from 18 centers of the Prospective Multicenter Radical Cystectomy Series 2011 (PROMETRICS 2011). To evaluate the influence of PDD conducted during primary or final TURBT on cancer-specific mortality (CSM) and overall mortality (OM) after RC, bootstrap-corrected multivariate Cox proportional-hazards regression models were applied (median follow-up: 25 months; IQR: 19-30). Sensitivity analyses were performed for both patients with pure urothelial carcinoma and patients undergoing one single TURBT only. RESULTS: In 88 (16.0 %) and 100 (18.2 %) patients, PDD was used in primary and final TURBTs, respectively. In 335 (61.0 %) patients, a single TURBT was performed prior to RC; in 194 patients (35.3 %), TURBT had been performed in a different center. CSM and OM rates at 3 years were 32 and 40 %, respectively. Use of PDD during primary or final TURBT was no independent predictor of CSM or OM. These results were internally valid and were confirmed in sensitivity analyses. CONCLUSIONS: PDD utilization during TURBT prior to RC does not independently impact the prognosis of BC patients after RC.
Authors: Marko Babjuk; Maximilian Burger; Richard Zigeuner; Shahrokh F Shariat; Bas W G van Rhijn; Eva Compérat; Richard J Sylvester; Eero Kaasinen; Andreas Böhle; Joan Palou Redorta; Morgan Rouprêt Journal: Eur Urol Date: 2013-06-12 Impact factor: 20.096
Authors: Matthias May; Patrick J Bastian; Maximilian Burger; Christian Bolenz; Lutz Trojan; Edwin Herrmann; Christian Wülfing; Stefan C Müller; Jörg Ellinger; Alexander Buchner; Christian G Stief; Derya Tilki; Wolfgang Otto; Thomas Höfner; Markus Hohenfellner; Axel Haferkamp; Jan Roigas; Mario Zacharias; Wolf F Wieland; Hans-Martin Fritsche Journal: BJU Int Date: 2011-06-23 Impact factor: 5.588
Authors: J Alfred Witjes; Eva Compérat; Nigel C Cowan; Maria De Santis; Georgios Gakis; Thierry Lebret; Maria J Ribal; Antoine G Van der Heijden; Amir Sherif Journal: Eur Urol Date: 2013-12-12 Impact factor: 20.096