mucosal lesions, 5,6 the handheld device seems to improve the access to difficult areas.In conclusion, our two cases support the possible application and usefulness of RCM for confirmation of inflammatory mucosal diseases, excluding tumoural processes and orienting the biopsy site selection. More advanced experiences on different oral mucosa diseases, also involving deeper areas of the oral cavity, are needed to demonstrate the effective usefulness of the handheld RCM in oral diseases diagnosis and patient management. References 1 Longo C, Zalaudek I, Argenziano G, Pellacani G. New directions in dermatopathology. in vivo confocal microscopy in clinical practice. Dermatol Clin 2012; 30: 799-814. 2 Contaldo M, Agozzino M, Moscarella E, Esposito S, Serpico R, Ardig o M. In vivo characterization of healthy oral mucosa by reflectance confocal microscopy: a translational research for optical biopsy. Ultrastruct Pathol 2013; 37: 151-158. 3 Alessi SS, Nico MM, Fernandes JD, Lourenc ßo SV. Reflectance confocal microscopy as a new tool in the in vivo evaluation of desquamative gingivitis: patterns in mucous membrane pemphigoid, pemphigus vulgaris and oral lichen planus. Br J Dermatol 2013; 168: 257-264. 4 Agozzino M, Bhasne P, Franceschini C, Vincenza G, Catrical a C, Ardig o M. Non-invasive, in vivo assessment of oral squamous cell carcinoma. Br J Dermatol 2014; 170: 754-756. 5 Cinotti E, Perrot JL, Labeille B, Adegbidi H, Cambazard F. Reflectance Confocal Microscopy for the diagnosis of vulvar melanoma and melanosis. Dermatol Surg 2012; 38: 1962-1967. 6 Ferrari A, Agozzino M, Ardig o M et al. Dermoscopic and Confocal Microscopy patterns of vulvar mucosal melanotic macules.
INTRODUCTION AND OBJECTIVES: BCG unresponsive bladder cancer has been sub-classified as refractory (persistent HG disease at 6 months) and relapsing (recurrent HG disease after achieving disease-free state at 6 months). The oncologic outcomes of the two subcategories following BCG unresponsive designation have not been compared.METHODS: We performed an IRB approved review of our bladder cancer database. Overall, 60 BCG refractory unresponsive and 32 relapsing unresponsive patients were identified. Salvage therapy was rendered at the discretion of the treating physician. Baseline clinicopathologic characteristics including age, gender, primary tumor grade, stage, size, multiplicity and concurrent CIS were collected and compared between the two groups. Recurrence free survival (RFS), progression free survival (PFS; with progression defined as the development of MIBC/distant metastasis), cystectomy free survival (CFS) and cancer specific survival (CSS) were compared. All tests were twosided and p<0.05 was considered statistically significant.RESULTS: Baseline clinicopathologic features including age (p¼0.45), tumor grade (p¼0.66), stage (p¼0.14), concurrent CIS (p¼0.18), and tumor multiplicity (p¼0.38) were similar between the two groups. On KM analysis, patients with BCG refractory and relapsing disease demonstrated similar RFS (Median 8mo, 95% CI 5-19mo vs. 14mo, 95% CI 4-33mo, p¼0.97) (Fig. 1a), PFS (Median NR vs. 74mo, 95% CI 38mo-NE, p¼0.95), CFS (Median NR vs. 27mo, 95% CI 14-61mo, p¼0.19) and CSS (Median NR vs. NR, p¼0.73). On univariate and multivariate analyses, BCG refractory and relapsing unresponsive disease were not found to independently predict RFS, PFS, CFS, or CSS.CONCLUSIONS: When strictly abiding by the definition of BCG unresponsive disease, BCG refractory unresponsive and BCG relapsing unresponsive patients had similar RFS, PFS, CFS, and CSS.
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