학술논문
Second TURB, restaging TURB or repeat TURB in primary T1 non-muscle invasive bladder cancer: impact on prognosis?
Document Type
Academic Journal
Author
Beijert IJ; Department of Surgical Oncology (Urology), Netherlands Cancer Institute-Antoni Van Leeuwenhoek Hospital, Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands.; Urology, Amsterdam University Medical Centers, Vrije Universiteit, Amsterdam, The Netherlands.; Hentschel AE; Department of Surgical Oncology (Urology), Netherlands Cancer Institute-Antoni Van Leeuwenhoek Hospital, Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands.; Urology, Amsterdam University Medical Centers, Vrije Universiteit, Amsterdam, The Netherlands.; Bründl J; Urology, Caritas St. Josef Medical Center, University of Regensburg, Regensburg, Germany.; Compérat EM; European Association of Urology, Non-Muscle Invasive Bladder Cancer Guidelines Panel, Arnhem, The Netherlands.; Pathology, Tenon Hospital, AP-HP, Sorbonne University, Paris, France.; Plass K; European Association of Urology, Guidelines Office Board, Arnhem, The Netherlands.; Rodríguez O; Urology, Fundacio Puigvert, Universitat Autònoma de Barcelona, Barcelona, Spain.; Subiela Henríquez JD; Urology, Fundacio Puigvert, Universitat Autònoma de Barcelona, Barcelona, Spain.; Hernández V; European Association of Urology, Non-Muscle Invasive Bladder Cancer Guidelines Panel, Arnhem, The Netherlands.; Urology, Hospital Universitario Fundación Alcorcón, Madrid, Spain.; de la Peña E; Urology, Hospital Universitario Fundación Alcorcón, Madrid, Spain.; Alemany I; Pathology, Hospital Universitario Fundación Alcorcón, Madrid, Spain.; Turturica D; Urology, Città della Salute e della Scienza, University of Torino School of Medicine, Turin, Italy.; Pisano F; Urology, Fundacio Puigvert, Universitat Autònoma de Barcelona, Barcelona, Spain.; Urology, Città della Salute e della Scienza, University of Torino School of Medicine, Turin, Italy.; Soria F; Urology, Città della Salute e della Scienza, University of Torino School of Medicine, Turin, Italy.; Čapoun O; European Association of Urology, Non-Muscle Invasive Bladder Cancer Guidelines Panel, Arnhem, The Netherlands.; Urology, General Teaching Hospital and 1st Faculty of Medicine, Charles University Praha, Prague, Czech Republic.; Bauerová L; Pathology, General Teaching Hospital and 1st Faculty of Medicine, Charles University Praha, Prague, Czech Republic.; Pešl M; Urology, General Teaching Hospital and 1st Faculty of Medicine, Charles University Praha, Prague, Czech Republic.; Bruins HM; European Association of Urology, Non-Muscle Invasive Bladder Cancer Guidelines Panel, Arnhem, The Netherlands.; Urology, Radboud University Medical Center, Nijmegen, The Netherlands.; Urology, Zuyderland Medical Center, Sittard/Heerlen, The Netherlands.; Runneboom W; Pathology, Radboud University Medical Center, Nijmegen, The Netherlands.; Herdegen S; Urology, Caritas St. Josef Medical Center, University of Regensburg, Regensburg, Germany.; Breyer J; Urology, Caritas St. Josef Medical Center, University of Regensburg, Regensburg, Germany.; Brisuda A; Urology, Teaching Hospital Motol and 2nd Faculty of Medicine, Charles University Praha, Prague, Czech Republic.; Calatrava A; Pathology, Fundación Instituto Valenciano de Oncología (I.V.O.), Valencia, Spain.; Rubio-Briones J; Urology, Fundación Instituto Valenciano de Oncología (I.V.O.), Valencia, Spain.; Seles M; Urology, Medical University of Graz, Graz, Austria.; Mannweiler S; Pathology, Medical University of Graz, Graz, Austria.; Bosschieter J; Urology, Amsterdam University Medical Centers, Vrije Universiteit, Amsterdam, The Netherlands.; Kusuma VRM; Urology, The Stokes Centre for Urology, Royal Surrey Hospital, Guildford, UK.; Ashabere D; Urology, The Stokes Centre for Urology, Royal Surrey Hospital, Guildford, UK.; Huebner N; Urology, Comprehensive Cancer Center, Medical University Vienna, Vienna General Hospital, Vienna, Austria.; Cotte J; Urology, Pitié Salpétrière Hospital, AP-HP, GRC no 5, ONCOTYPE-URO, Sorbonne University, 75013, Paris, France.; Contieri R; Department of Surgical Oncology (Urology), Netherlands Cancer Institute-Antoni Van Leeuwenhoek Hospital, Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands.; Mertens LS; Department of Surgical Oncology (Urology), Netherlands Cancer Institute-Antoni Van Leeuwenhoek Hospital, Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands.; Claps F; Department of Surgical Oncology (Urology), Netherlands Cancer Institute-Antoni Van Leeuwenhoek Hospital, Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands.; Masson-Lecomte A; European Association of Urology, Non-Muscle Invasive Bladder Cancer Guidelines Panel, Arnhem, The Netherlands.; Liedberg F; European Association of Urology, Non-Muscle Invasive Bladder Cancer Guidelines Panel, Arnhem, The Netherlands.; Cohen D; European Association of Urology, Non-Muscle Invasive Bladder Cancer Guidelines Panel, Arnhem, The Netherlands.; Urology, Royal Free London-NHS Foundation Trust, Royal Free Hospital, London, UK.; Lunelli L; Urology, Tenon Hospital, AP-HP, Sorbonne University, Paris, France.; Cussenot O; Urology, Tenon Hospital, AP-HP, Sorbonne University, Paris, France.; El Sheikh S; Pathology, Royal Free London-NHS Foundation Trust, Royal Free Hospital, London, UK.; Volanis D; Urology, Royal Free London-NHS Foundation Trust, Royal Free Hospital, London, UK.; Côté JF; Pathology, Pierre et Marie Curie Medical School, Pitié Salpétrière Hospital, AP-HP, Sorbonne University, Paris, France.; Rouprêt M; European Association of Urology, Non-Muscle Invasive Bladder Cancer Guidelines Panel, Arnhem, The Netherlands.; Urology, Pitié Salpétrière Hospital, AP-HP, GRC no 5, ONCOTYPE-URO, Sorbonne University, 75013, Paris, France.; Haitel A; Pathology, Comprehensive Cancer Center, Medical University Vienna, Vienna General Hospital, Vienna, Austria.; Shariat SF; European Association of Urology, Non-Muscle Invasive Bladder Cancer Guidelines Panel, Arnhem, The Netherlands.; Urology, Teaching Hospital Motol and 2nd Faculty of Medicine, Charles University Praha, Prague, Czech Republic.; Urology, Comprehensive Cancer Center, Medical University Vienna, Vienna General Hospital, Vienna, Austria.; Mostafid AH; European Association of Urology, Non-Muscle Invasive Bladder Cancer Guidelines Panel, Arnhem, The Netherlands.; Urology, The Stokes Centre for Urology, Royal Surrey Hospital, Guildford, UK.; Nieuwenhuijzen JA; Urology, Amsterdam University Medical Centers, Vrije Universiteit, Amsterdam, The Netherlands.; Zigeuner R; European Association of Urology, Non-Muscle Invasive Bladder Cancer Guidelines Panel, Arnhem, The Netherlands.; Urology, Medical University of Graz, Graz, Austria.; Dominguez-Escrig JL; European Association of Urology, Non-Muscle Invasive Bladder Cancer Guidelines Panel, Arnhem, The Netherlands.; Urology, Fundación Instituto Valenciano de Oncología (I.V.O.), Valencia, Spain.; Hacek J; Pathology, Teaching Hospital Motol and 2nd Faculty of Medicine, Charles University Praha, Prague, Czech Republic.; Zlotta AR; Surgical Oncology (Urology), University Health Network, Princess Margaret Cancer Center, University of Toronto, Toronto, Canada.; Burger M; Urology, Caritas St. Josef Medical Center, University of Regensburg, Regensburg, Germany.; European Association of Urology, Non-Muscle Invasive Bladder Cancer Guidelines Panel, Arnhem, The Netherlands.; Evert M; Pathology, University of Regensburg, Regensburg, Germany.; Hulsbergen-van de Kaa CA; Pathology, Radboud University Medical Center, Nijmegen, The Netherlands.; van der Heijden AG; Urology, Radboud University Medical Center, Nijmegen, The Netherlands.; Kiemeney LALM; Health Evidence and Urology, Radboud University Medical Center, Nijmegen, The Netherlands.; Soukup V; European Association of Urology, Non-Muscle Invasive Bladder Cancer Guidelines Panel, Arnhem, The Netherlands.; Urology, General Teaching Hospital and 1st Faculty of Medicine, Charles University Praha, Prague, Czech Republic.; Molinaro L; Pathology, Città della Salute e della Scienza, University of Torino School of Medicine, Turin, Italy.; Gontero P; European Association of Urology, Non-Muscle Invasive Bladder Cancer Guidelines Panel, Arnhem, The Netherlands.; Urology, Città della Salute e della Scienza, University of Torino School of Medicine, Turin, Italy.; Llorente C; Urology, Hospital Universitario Fundación Alcorcón, Madrid, Spain.; Algaba F; Pathology, Fundacio Puigvert, Universitat Autònoma de Barcelona, Barcelona, Spain.; Palou J; European Association of Urology, Non-Muscle Invasive Bladder Cancer Guidelines Panel, Arnhem, The Netherlands.; Urology, Fundacio Puigvert, Universitat Autònoma de Barcelona, Barcelona, Spain.; N'Dow J; European Association of Urology, Guidelines Office Board, Arnhem, The Netherlands.; Ribal MJ; European Association of Urology, Guidelines Office Board, Arnhem, The Netherlands.; van der Kwast TH; Laboratory Medicine Program, University Health Network, Princess Margaret Cancer Center, University of Toronto, Toronto, Canada.; Babjuk M; European Association of Urology, Non-Muscle Invasive Bladder Cancer Guidelines Panel, Arnhem, The Netherlands.; Urology, Teaching Hospital Motol and 2nd Faculty of Medicine, Charles University Praha, Prague, Czech Republic.; Urology, Comprehensive Cancer Center, Medical University Vienna, Vienna General Hospital, Vienna, Austria.; Sylvester RJ; European Association of Urology, Non-Muscle Invasive Bladder Cancer Guidelines Panel, Arnhem, The Netherlands.; van Rhijn BWG; Department of Surgical Oncology (Urology), Netherlands Cancer Institute-Antoni Van Leeuwenhoek Hospital, Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands. b.v.rhijn@nki.nl.; Urology, Caritas St. Josef Medical Center, University of Regensburg, Regensburg, Germany. b.v.rhijn@nki.nl.; European Association of Urology, Non-Muscle Invasive Bladder Cancer Guidelines Panel, Arnhem, The Netherlands. b.v.rhijn@nki.nl.; Surgical Oncology (Urology), University Health Network, Princess Margaret Cancer Center, University of Toronto, Toronto, Canada. b.v.rhijn@nki.nl.
Source
Publisher: Springer Country of Publication: Netherlands NLM ID: 0262521 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1573-2584 (Electronic) Linking ISSN: 03011623 NLM ISO Abbreviation: Int Urol Nephrol Subsets: MEDLINE
Subject
Language
English
Abstract
Purpose: A re-transurethral resection of the bladder (re-TURB) is a well-established approach in managing non-muscle invasive bladder cancer (NMIBC) for various reasons: repeat-TURB is recommended for a macroscopically incomplete initial resection, restaging-TURB is required if the first resection was macroscopically complete but contained no detrusor muscle (DM) and second-TURB is advised for all completely resected T1-tumors with DM in the resection specimen. This study assessed the long-term outcomes after repeat-, second-, and restaging-TURB in T1-NMIBC patients.
Methods: Individual patient data with tumor characteristics of 1660 primary T1-patients (muscle-invasion at re-TURB omitted) diagnosed from 1990 to 2018 in 17 hospitals were analyzed. Time to recurrence, progression, death due to bladder cancer (BC), and all causes (OS) were visualized with cumulative incidence functions and analyzed by log-rank tests and multivariable Cox-regression models stratified by institution.
Results: Median follow-up was 45.3 (IQR 22.7-81.1) months. There were no differences in time to recurrence, progression, or OS between patients undergoing restaging (135 patients), second (644 patients), or repeat-TURB (84 patients), nor between patients who did or who did not undergo second or restaging-TURB. However, patients who underwent repeat-TURB had a shorter time to BC death compared to those who had second- or restaging-TURB (multivariable HR 3.58, P = 0.004).
Conclusion: Prognosis did not significantly differ between patients who underwent restaging- or second-TURB. However, a worse prognosis in terms of death due to bladder cancer was found in patients who underwent repeat-TURB compared to second-TURB and restaging-TURB, highlighting the importance of separately evaluating different indications for re-TURB.
(© 2023. The Author(s), under exclusive licence to Springer Nature B.V.)
Methods: Individual patient data with tumor characteristics of 1660 primary T1-patients (muscle-invasion at re-TURB omitted) diagnosed from 1990 to 2018 in 17 hospitals were analyzed. Time to recurrence, progression, death due to bladder cancer (BC), and all causes (OS) were visualized with cumulative incidence functions and analyzed by log-rank tests and multivariable Cox-regression models stratified by institution.
Results: Median follow-up was 45.3 (IQR 22.7-81.1) months. There were no differences in time to recurrence, progression, or OS between patients undergoing restaging (135 patients), second (644 patients), or repeat-TURB (84 patients), nor between patients who did or who did not undergo second or restaging-TURB. However, patients who underwent repeat-TURB had a shorter time to BC death compared to those who had second- or restaging-TURB (multivariable HR 3.58, P = 0.004).
Conclusion: Prognosis did not significantly differ between patients who underwent restaging- or second-TURB. However, a worse prognosis in terms of death due to bladder cancer was found in patients who underwent repeat-TURB compared to second-TURB and restaging-TURB, highlighting the importance of separately evaluating different indications for re-TURB.
(© 2023. The Author(s), under exclusive licence to Springer Nature B.V.)