Chiara Lonati1,2, Luca Afferi3, Andrea Mari4, Andrea Minervini4, Wojciech Krajewski5, Marco Borghesi6, Gerald B Schulz7, Michael Rink8, Francesco Montorsi9,10, Alberto Briganti9,10, Renzo Colombo9, Alberto Martini9, Andrea Necchi10,11, Roberto Contieri12, Rodolfo Hurle12, Paolo Umari13, Stefania Zamboni14, Claudio Simeone14, Francesco Soria15, Giancarlo Marra15, Paolo Gontero15, Jeremy Yuen-Chun Teoh16, Tobias Klatte17, Anne-Sophie Bajeot18, Mathieu Roumiguié18, Morgan Rouprêt19, Alexandra Masson-Lecomte20, Ekaterina Laukhtina21,22, Anne Sophie Valiquette23, M Carmen Mir23, Alessandro Antonelli24, Sarah M H Einerhand25, Kees Hendricksen25, Roberto Carando3,26,27,28, Christian D Fankhauser3, Philipp Baumeister3, Agostino Mattei3, Shahrokh F Shariat21,22,29,30,31, Marco Moschini3,9. 1. Department of Urology, Spedali Civili di Brescia, piazzale Spedali Civili 1, 25123, Brescia, Italy. chiara.lonati@libero.it. 2. Department of Urology, Luzerner Kantonsspital, Lucerne, Switzerland. chiara.lonati@libero.it. 3. Department of Urology, Luzerner Kantonsspital, Lucerne, Switzerland. 4. Department of Experimental and Clinical Medicine, Unit of Oncologic Minimally-Invasive Urology and Andrology, University of Florence, Careggi University Hospital, Florence, Italy. 5. Department of Urology and Oncological Urology, Wrocław Medical University, Wrocław, Poland. 6. Department of Urology, Policlinico San Martino Hospital, University of Genova, Genova, Italy. 7. Department of Urology, Ludwig-Maximilians-University, Munich, Germany. 8. Department of Urology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany. 9. Division of Experimental Oncology/Unit of Urology, Urological Research Institute, IRCCS Ospedale San Raffaele, Milan, Italy. 10. University Vita-Salute San Raffaele, Milan, Italy. 11. Department of Medical Oncology, IRCCS Ospedale San Raffaele, Milan, Italy. 12. Department of Urology, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy. 13. Division of Surgery and Interventional Science, University College London, London, UK. 14. Department of Urology, Spedali Civili di Brescia, piazzale Spedali Civili 1, 25123, Brescia, Italy. 15. Division of Urology, Department of Surgical Sciences, AOU Città della Salute e della Scienza di Torino, Torino School of Medicine, Torino, Italy. 16. Department of Surgery, Prince of wales Hospital, The Chinese University of Hong Kong, Hong Kong, China. 17. Department of Urology, Charité, Universitätsmedizin Berlin, Berlin, Germany. 18. Department of Urology, Centre Hospitalier Universitaire (CHU) de Toulouse, Toulouse, France. 19. GRC 5 Predictive Onco-Uro, AP-HP, Urology, Sorbonne University, Pitie-Salpetriere Hospital, 75013, Paris, France. 20. APHP, Department of Urology, Hôpital Saint Louis, Université de Paris, Paris, France. 21. Institute for Urology and Reproductive Health, Sechenov University, Moscow, Russia. 22. Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna General Hospital, Vienna, Austria. 23. Department of Urology, Fundación Instituto Valenciano de Oncologia, Valencia, Spain. 24. Department of Urology, University of Verona, Azienda Ospedaliera Universitaria Integrata Verona, Verona, Italy. 25. Department of Urology, The Netherlands Cancer Institute, Amsterdam, The Netherlands. 26. Clinica Luganese Moncucco, Lugano, Switzerland. 27. Clinica S.Anna, Swiss Medical Group, Sorengo, Switzerland. 28. Clinica Santa Chiara, Locarno, Switzerland. 29. Department of Urology, Weill Cornell Medical College, New York, NY, USA. 30. Department of Urology, University of Texas Southwestern Medical Center, Dallas, TX, USA. 31. Department of Urology, Second Faculty of Medicine, Charles University, Prague, Czech Republic.
Abstract
PURPOSE: To compare cancer-specific mortality (CSM) and overall mortality (OM) between immediate radical cystectomy (RC) and Bacillus Calmette-Guérin (BCG) immunotherapy for T1 squamous bladder cancer (BCa). METHODS: We retrospectively analysed 188 T1 high-grade squamous BCa patients treated between 1998 and 2019 at fifteen tertiary referral centres. Median follow-up time was 36 months (interquartile range: 19-76). The cumulative incidence and Kaplan-Meier curves were applied for CSM and OM, respectively, and compared with the Pepe-Mori and log-rank tests. Multivariable Cox models, adjusted for pathological findings at initial transurethral resection of bladder (TURB) specimen, were adopted to predict tumour recurrence and tumour progression after BCG immunotherapy. RESULTS: Immediate RC and conservative management were performed in 20% and 80% of patients, respectively. 5-year CSM and OM did not significantly differ between the two therapeutic strategies (Pepe-Mori test p = 0.052 and log-rank test p = 0.2, respectively). At multivariable Cox analyses, pure squamous cell carcinoma (SqCC) was an independent predictor of tumour progression (p = 0.04), while concomitant lympho-vascular invasion (LVI) was an independent predictor of both tumour recurrence and progression (p = 0.04) after BCG. Patients with neither pure SqCC nor LVI showed a significant benefit in 3-year recurrence-free survival and progression-free survival compared to individuals with pure SqCC or LVI (60% vs. 44%, p = 0.04 and 80% vs. 68%, p = 0.004, respectively). CONCLUSION: BCG could represent an effective treatment for T1 squamous BCa patients with neither pure SqCC nor LVI, while immediate RC should be preferred among T1 squamous BCa patients with pure SqCC or LVI at initial TURB specimen.
PURPOSE: To compare cancer-specific mortality (CSM) and overall mortality (OM) between immediate radical cystectomy (RC) and Bacillus Calmette-Guérin (BCG) immunotherapy for T1 squamous bladder cancer (BCa). METHODS: We retrospectively analysed 188 T1 high-grade squamous BCa patients treated between 1998 and 2019 at fifteen tertiary referral centres. Median follow-up time was 36 months (interquartile range: 19-76). The cumulative incidence and Kaplan-Meier curves were applied for CSM and OM, respectively, and compared with the Pepe-Mori and log-rank tests. Multivariable Cox models, adjusted for pathological findings at initial transurethral resection of bladder (TURB) specimen, were adopted to predict tumour recurrence and tumour progression after BCG immunotherapy. RESULTS: Immediate RC and conservative management were performed in 20% and 80% of patients, respectively. 5-year CSM and OM did not significantly differ between the two therapeutic strategies (Pepe-Mori test p = 0.052 and log-rank test p = 0.2, respectively). At multivariable Cox analyses, pure squamous cell carcinoma (SqCC) was an independent predictor of tumour progression (p = 0.04), while concomitant lympho-vascular invasion (LVI) was an independent predictor of both tumour recurrence and progression (p = 0.04) after BCG. Patients with neither pure SqCC nor LVI showed a significant benefit in 3-year recurrence-free survival and progression-free survival compared to individuals with pure SqCC or LVI (60% vs. 44%, p = 0.04 and 80% vs. 68%, p = 0.004, respectively). CONCLUSION: BCG could represent an effective treatment for T1 squamous BCa patients with neither pure SqCC nor LVI, while immediate RC should be preferred among T1 squamous BCa patients with pure SqCC or LVI at initial TURB specimen.
Authors: Marko Babjuk; Maximilian Burger; Eva M Compérat; Paolo Gontero; A Hugh Mostafid; Joan Palou; Bas W G van Rhijn; Morgan Rouprêt; Shahrokh F Shariat; Richard Sylvester; Richard Zigeuner; Otakar Capoun; Daniel Cohen; José Luis Dominguez Escrig; Virginia Hernández; Benoit Peyronnet; Thomas Seisen; Viktor Soukup Journal: Eur Urol Date: 2019-08-20 Impact factor: 20.096
Authors: Niyati Lobo; Shahrokh F Shariat; Charles Chuanhai Guo; Mario I Fernandez; Wassim Kassouf; Ananya Choudhury; Jianjun Gao; Stephen B Williams; Matthew D Galsky; John A Taylor; Morgan Roupret; Ashish M Kamat Journal: Eur Urol Focus Date: 2019-09-15
Authors: A Horwich; M Babjuk; J Bellmunt; H M Bruins; T M De Reijke; M De Santis; S Gillessen; N James; S Maclennan; J Palou; T Powles; M J Ribal; S F Shariat; T Van Der Kwast; E Xylinas; N Agarwal; T Arends; A Bamias; A Birtle; P C Black; B H Bochner; M Bolla; J L Boormans; A Bossi; A Briganti; I Brummelhuis; M Burger; D Castellano; R Cathomas; A Chiti; A Choudhury; E Compérat; S Crabb; S Culine; B De Bari; W DeBlok; P J L De Visschere; K Decaestecker; K Dimitropoulos; J L Dominguez-Escrig; S Fanti; V Fonteyne; M Frydenberg; J J Futterer; G Gakis; B Geavlete; P Gontero; B Grubmüller; S Hafeez; D E Hansel; A Hartmann; D Hayne; A M Henry; V Hernandez; H Herr; K Herrmann; P Hoskin; J Huguet; B A Jereczek-Fossa; R Jones; A M Kamat; V Khoo; A E Kiltie; S Krege; S Ladoire; P C Lara; A Leliveld; E Linares-Espinós; V Løgager; A Lorch; Y Loriot; R Meijer; M Carmen Mir; M Moschini; H Mostafid; A-C Müller; C R Müller; J N'Dow; A Necchi; Y Neuzillet; J R Oddens; J Oldenburg; S Osanto; W J G Oyen; L Pacheco-Figueiredo; H Pappot; M I Patel; B R Pieters; K Plass; M Remzi; M Retz; J Richenberg; M Rink; F Roghmann; J E Rosenberg; M Rouprêt; O Rouvière; C Salembier; A Salminen; P Sargos; S Sengupta; A Sherif; R J Smeenk; A Smits; A Stenzl; G N Thalmann; B Tombal; B Turkbey; S Vahr Lauridsen; R Valdagni; A G Van Der Heijden; H Van Poppel; M D Vartolomei; E Veskimäe; A Vilaseca; F A Vives Rivera; T Wiegel; P Wiklund; A Williams; R Zigeuner; J A Witjes Journal: Ann Oncol Date: 2019-11-01 Impact factor: 32.976
Authors: Marina Deuker; L Franziska Stolzenbach; Giuseppe Rosiello; Stefano Luzzago; Thomas Martin; Zhe Tian; Derya Tilki; Shahrokh F Shariat; Fred Saad; Wassim Kassouf; Peter C Black; Felix K H Chun; Pierre I Karakiewicz Journal: Eur J Surg Oncol Date: 2020-05-12 Impact factor: 4.424
Authors: Ashwin S Balakrishnan; Samuel L Washington; Maxwell V Meng; Sima P Porten Journal: Clin Genitourin Cancer Date: 2019-01-19 Impact factor: 2.872
Authors: J Alfred Witjes; Marek Babjuk; Joaquim Bellmunt; H Maxim Bruins; Theo M De Reijke; Maria De Santis; Silke Gillessen; Nicholas James; Steven Maclennan; Juan Palou; Tom Powles; Maria J Ribal; Shahrokh F Shariat; Theo Van Der Kwast; Evanguelos Xylinas; Neeraj Agarwal; Tom Arends; Aristotle Bamias; Alison Birtle; Peter C Black; Bernard H Bochner; Michel Bolla; Joost L Boormans; Alberto Bossi; Alberto Briganti; Iris Brummelhuis; Max Burger; Daniel Castellano; Richard Cathomas; Arturo Chiti; Ananya Choudhury; Eva Compérat; Simon Crabb; Stephane Culine; Berardino De Bari; Willem De Blok; Pieter J L De Visschere; Karel Decaestecker; Konstantinos Dimitropoulos; Jose L Dominguez-Escrig; Stefano Fanti; Valerie Fonteyne; Mark Frydenberg; Jurgen J Futterer; Georgios Gakis; Bogdan Geavlete; Paolo Gontero; Bernhard Grubmüller; Shaista Hafeez; Donna E Hansel; Arndt Hartmann; Dickon Hayne; Ann M Henry; Virginia Hernandez; Harry Herr; Ken Herrmann; Peter Hoskin; Jorge Huguet; Barbara A Jereczek-Fossa; Rob Jones; Ashish M Kamat; Vincent Khoo; Anne E Kiltie; Susanne Krege; Sylvain Ladoire; Pedro C Lara; Annemarie Leliveld; Estefania Linares-Espinós; Vibeke Løgager; Anja Lorch; Yohann Loriot; Richard Meijer; M Carmen Mir; Marco Moschini; Hugh Mostafid; Arndt-Christian Müller; Christoph R Müller; James N'Dow; Andrea Necchi; Yann Neuzillet; Jorg R Oddens; Jan Oldenburg; Susanne Osanto; Wim J G Oyen; Luís Pacheco-Figueiredo; Helle Pappot; Manish I Patel; Bradley R Pieters; Karin Plass; Mesut Remzi; Margitta Retz; Jonathan Richenberg; Michael Rink; Florian Roghmann; Jonathan E Rosenberg; Morgan Rouprêt; Olivier Rouvière; Carl Salembier; Antti Salminen; Paul Sargos; Shomik Sengupta; Amir Sherif; Robert J Smeenk; Anita Smits; Arnulf Stenzl; George N Thalmann; Bertrand Tombal; Baris Turkbey; Susanne Vahr Lauridsen; Riccardo Valdagni; Antoine G Van Der Heijden; Hein Van Poppel; Mihai D Vartolomei; Erik Veskimäe; Antoni Vilaseca; Franklin A Vives Rivera; Thomas Wiegel; Peter Wiklund; Andrew Williams; Richard Zigeuner; Alan Horwich Journal: Eur Urol Date: 2019-11-19 Impact factor: 20.096
Authors: Severin Rodler; Alexander Buchner; Stephan T Ledderose; Lennert Eismann; Yannic Volz; Paulo Pfitzinger; Alexander Kretschmer; Gerald B Schulz; Alexander Karl; Boris Schlenker; Christian G Stief; Friedrich Jokisch Journal: World J Urol Date: 2020-10-21 Impact factor: 4.226