T1 bladder cancer in Norway: treatment and survival

Blindheim, Augun; Fosså, Sophie D.; Babigumira, Ronnie; Myklebust, Tor Åge; Haug, Erik Skaaheim; Arum, C.J.; Andreassen, Bettina Kulle

doi:10.1080/21681805.2020.1803401

Cited by 5 publications

(4 citation statements)

References 27 publications

(38 reference statements)

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“…Survival estimates for T1 patients vary considerably in the literature, reflecting differences in study populations and methods from modeling survival. Blindheim et al reported that the 5-year survival rates for all T1 bladder cancer patients were 84% (cause-specific survival) and 65% (OS) (13).…”

Section: Discussionmentioning

confidence: 99%

Value of tumor’s depth and width in predicting survival rate in non-muscle- invasive (pT1) bladder cancer

Albert¹,

Tampubolon²,

Pramod³

et al. 2022

Ann Afr Surg.

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Background: Bladder cancer is classified according to traditional American Joint Committee on Cancer TNM staging. In the absence of nodal (N stage) or distant metastases (M stage), the depth of tumor invasion (T stage) is the most important determination to be made: whether the tumor is invading into or beyond the lamina propria (muscle-invasive bladder cancer) or not (non- muscle-invasive bladder cancer). This study investigated the association between the cutoff value of tumor depth and width and survival rate in non-muscle- invasive (pT1) bladder cancer. Methods: This was a retrospective cohort design of randomly selected, single- centered study. The subjects were patients with pT1 urothelial carcinoma who were diagnosed on transurethral resection of bladder specimens at a tertiary hospital in West Java, Indonesia. The research sample was taken by consecutive sampling from 2015 to 2019. Results: Sixty-four patients from were included in this study. A tumor depth >2 mm resulted in a hazard ratio (HR) of 1.41 (95% confidence interval [CI], 1.27–3.94; p<0.007), with significant difference. A tumor width >2.4 mm also increased HR significantly (3.27; 95% CI, 1.69–5.87; p<0.006). The presence of lymphovascular invasion (LVI) in patients with bladder cancer resulted in an HR of 3.66 (95% CI, 1.5–4.77; p<0.001), with statistically significant difference in overall survival (OS). Conclusion: Tumor invasion depth, tumor width, and LVI appear to be predictive of poor prognosis in terms of OS in patients with pT1 bladder cancer.

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Section: Discussionmentioning

confidence: 99%

Value of tumor’s depth and width in predicting survival rate in non-muscle- invasive (pT1) bladder cancer

Albert¹,

Tampubolon²,

Pramod³

et al. 2022

Ann Afr Surg.

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“…The suboptimal adoption of BCG instillations, however, has been commonly reported in the published literature. A recent population-based Scandinavian study ( 29 ) reports the total rate of T1 patients treated with BCG either early or delayed as 41%, with only 15% receiving BCG as early treatment (within 8 weeks after final diagnosis). In a Swedish T1 nationwide population-based study, the BCG rate was somewhat higher at ~50% ( 30 ).…”

Section: Discussionmentioning

confidence: 99%

T1 Bladder Cancer: Comparison of the Prognostic Impact of Two Substaging Systems on Disease Recurrence and Progression and Suggestion of a Novel Nomogram

et al. 2021

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Background: The T1 substaging of bladder cancer (BCa) potentially impacts disease progression. The objective of the study was to compare the prognostic accuracy of two substaging systems on the recurrence and progression of primary pathologic T1 (pT1) BCa and to test a nomogram based on pT1 substaging for predicting recurrence-free survival (RFS) and progression-free survival (PFS).Methods: The medical records of 204 patients affected by pT1 BCa were retrospectively reviewed. Substaging was defined according to the depth of lamina propria invasion in T1a−c and the extension of the lamina propria invasion to T1-microinvasive (T1m) or T1-extensive (T1e). Uni- and multivariable Cox regression models evaluated the independent variables correlated with recurrence and progression. The predictive accuracies of the two substaging systems were compared by Harrell's C index. Multivariate Cox regression models for the RFS and PFS were also depicted by a nomogram.Results: The 5-year RFS was 47.5% with a significant difference between T1c and T1a (p = 0.02) and between T1e and T1m (p < 0.001). The 5-year PFS was 75.9% with a significant difference between T1c and T1a (p = 0.011) and between T1e and T1m (p < 0.001). Model T1m−e showed a higher predictive power than T1a−c for predicting RFS and PFS. In the univariate and multivariate model subcategory T1e, the diameter, location, and number of tumors were confirmed as factors influencing recurrence and progression after adjusting for the other variables. The nomogram incorporating the T1m−e model showed a satisfactory agreement between model predictions at 5 years and actual observations.Conclusions: Substaging is significantly associated with RFS and PFS for patients affected by T1 BCa and should be included in innovative prognostic nomograms.

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“…About half of the patients with a muscle invasive tumor and about one third of those with a T1 tumor at reTURB underwent early cystectomy. We have previously shown [25] that T1 patients <75 years as well as patients with high grade tumors or concomitant cis were most likely to undergo cystectomy within 6 months after primTURB or reTURB respectively. Additional factors for not performing or delaying cystectomy could have been severe comorbidity or the patient's refusal.…”

Section: Post Returb Treatmentmentioning

confidence: 99%

“…Additional factors for not performing or delaying cystectomy could have been severe comorbidity or the patient's refusal. Both clinicians and patients should be aware that survival is unfavorable in some patients undergoing deferred cystectomy [25,26]. Moschini et al even found increased mortality rates for T1 patients with cystectomy after progression to muscle invasive disease compared to mortality for primary muscle invasive bladder cancer [27].…”

Section: Post Returb Treatmentmentioning

confidence: 99%

The use of reTURB in T1 bladder cancer: a Norwegian population-based study

Blindheim

Fosså

Babigumira

et al. 2021

Scandinavian Journal of Urology

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Aim: To evaluate the use of repeat transurethral resection of the bladder (reTURB) in stage T1 bladder cancer and its impact on treatment and survival in a Norwegian population-based cohort. Material and methods: 1130 patients registered at the Cancer Registry of Norway between 2008 and 2012 with primary urothelial T1 cancer were included. Information on surgical and medical procedures was provided by the Norwegian Patient Registry. Descriptive statistics were used to evaluate characteristics of patients receiving reTURB or not within 12 weeks from primary TURB (primTURB). Survival models identified risk factors and estimated cause-specific survival rates (CSS) adjusted for sex, age, WHO grade, concomitant cis and detrusor muscle at primTURB and treatment. Results: The 648 (57%) T1 patients with reTURB were significantly younger and had more WHO high grade tumors compared to those without reTURB. Of 275 patients without detrusor muscle at primTURB 114 (41%) had no reTURB. Of reTURB patients, 45 (7%) had muscle invasive tumor, 110 (17%) T1 and 378 (58%) Ta, cis or T0. Two-thirds of 81 patients receiving early cystectomy after reTURB had T1 or muscle invasive bladder cancer at reTURB. ReTURB did not impact adjusted CSS, but patients with T1 at reTURB had significantly lower CSS than those with < T1 conditions. Conclusions: Almost half of the T1 patients did not undergo reTURB as recommended in guidelines. We show that reTURB makes the histology result more reliable with impact on both treatment and survival. Our results support the use of reTURB as recommended by EAU guidelines.

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T1 bladder cancer in Norway: treatment and survival

Cited by 5 publications

References 27 publications

Value of tumor’s depth and width in predicting survival rate in non-muscle- invasive (pT1) bladder cancer

Value of tumor’s depth and width in predicting survival rate in non-muscle- invasive (pT1) bladder cancer

T1 Bladder Cancer: Comparison of the Prognostic Impact of Two Substaging Systems on Disease Recurrence and Progression and Suggestion of a Novel Nomogram

The use of reTURB in T1 bladder cancer: a Norwegian population-based study

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