Tumor size and T stage correlate independently with recurrence and progression in high-risk non-muscle-invasive bladder cancer patients treated with adjuvant BCG

Zachos, Ioannis; Tzortzis, Vassilios; Mitrakas, Lampros; Samarinas, Michael; Karatzas, Anastasios; Gravas, Stavros; Vandoros, Gerasimos P.; Melekos, Michael D.; Papavassiliou, Athanasios G.

doi:10.1007/s13277-013-1547-8

Cited by 17 publications

(12 citation statements)

References 18 publications

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“…Rianne concluded that multiple tumors increased the risk of recurrences by 1.56-1.8 in comparison with single tumors in Dutch cohort ( n = 724) and Spanish cohort ( n = 137) [ 13 ]. Similarly, in high-risk non-muscle-invasive bladder cancer patients treated with adjuvant BCG, tumor size was found to correlate with recurrence and progression [ 14 ]. To our best knowledge, it is the first time to prompt that SD can predict poor response to intravesical chemotherapy in pT1 bladder urothelial carcinoma.…”

Section: Discussionmentioning

confidence: 99%

Squamous differentiation in pT1 bladder urothelial carcinoma predicts poor response for intravesical chemotherapy

Niu

2017

Oncotarget

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The role of squamous differentiation in pT1 bladder tumors in the response to intravesical chemotherapy was unknown. We performed a retrospective analysis of 213 pT1 bladder urothelial carcinoma patients with squamous differentiation (group1), the remaining 213 pT1 pure urothelial carcinoma served as controls (group2). All cases were treated with transurethral resection of bladder tumor and subsequent intravesical chemotherapy. Within a five-year period, the tumor recurrence rate was 75.1% (160/213) in group 1 and 64.3% (137/213) in group 2. Tumor grade (HR = 2.926, P = 0.014), number of tumors (HR = 2.130, P = 0.038), tumor size (HR = 2.748, P = 0.031), and squamous differentiation (HR = 3.726, P = 0.019) were found to be important prognostic factors. Subgroup analysis for high grade tumors was performed, finding that group 1 had higher recurrence rate (50.3% vs 36.3%; for group 2). Progression was found in 32.2% (30/160) of group1 and 15.1% (11/137) of group2 (P = 0.011). Our data suggests that squamous differentiation is a predictor of poor response for intravesical chemotherapy, and that early radical cystectomy should be performed for high grade tumors, especially when dealing with recurrent cases.

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Section: Discussionmentioning

confidence: 99%

Squamous differentiation in pT1 bladder urothelial carcinoma predicts poor response for intravesical chemotherapy

Niu

2017

Oncotarget

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“…Of the multiple factors including age, gender, CIS, stage, number of tumors, and tumor size for NMIBC patients treated with BCG, tumor size of > 3 cm in diameter was associated with BC recurrence, whereas tumor stage (Ta or T1) was associated with tumor progression [30] . In intermediate and high-risk NMIBC patients treated with BCG, older cohort exhibited unfavorable long-term prognosis [31] .…”

Section: Biological Markers: General Notesmentioning

confidence: 99%

Treatment of non-muscle invasive bladder cancer with Bacillus Calmette–Guerin (BCG): Biological markers and simulation studies

Kiselyov

Bunimovich‐Mendrazitsky

Startsev

2015

BBA Clinical

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Intravesical Bacillus Calmette–Guerin (BCG) vaccine is the preferred first line treatment for non-muscle invasive bladder carcinoma (NMIBC) in order to prevent recurrence and progression of cancer. There is ongoing need for the rational selection of i) BCG dose, ii) frequency of BCG administration along with iii) synergistic adjuvant therapy and iv) a reliable set of biochemical markers relevant to tumor response. In this review we evaluate cellular and molecular markers pertinent to the immunological response triggered by the BCG instillation and respective mathematical models of the treatment. Specific examples of markers include diverse immune cells, genetic polymorphisms, miRNAs, epigenetics, immunohistochemistry and molecular biology ‘beacons’ as exemplified by cell surface proteins, cytokines, signaling proteins and enzymes. We identified tumor associated macrophages (TAMs), human leukocyte antigen (HLA) class I, a combination of Ki-67/CK20, IL-2, IL-8 and IL-6/IL-10 ratio as the most promising markers for both pre-BCG and post-BCG treatment suitable for the simulation studies.The intricate and patient-specific nature of these data warrants the use of powerful multi-parametral mathematical methods in combination with molecular/cellular biology insight and clinical input.

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“… 13 In high-risk NMIBC (Ta, T1) patients treated with BCG, tumor size (<3 cm, ≥3 cm) and T stage (Ta, T1) correlated with recurrence and progression, respectively. 12 Female sex was related to worse RFS, PFS, and cancer-specific survival (CSS) in patients with T1HG disease. 8 9 Other prognostic factors were also evaluated in several studies.…”

Section: Discussionmentioning

confidence: 99%

“… 5 6 In addition, many studies have investigated the potential prognostic value of multiple factors, including sex, age, smoking, preoperative urine cytology result, tumor size, tumor morphology, tumor multiplicity, CIS, included muscle layer, lymphovascular invasion (LVI), restaging transurethral resection (TUR), and intravesical BCG therapy, in association with the recurrence and progression of NMIBC. 7 8 9 10 11 12 13 The prognostic value of several of these factors has been established, while such value remains controversial for others.…”

Section: Introductionmentioning

confidence: 99%

Prognostic Factors for Recurrence and Progression in Korean Non-Muscle-Invasive Bladder Cancer Patients: A Retrospective, Multi-Institutional Study

Kim

et al. 2016

Yonsei Med J

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PurposeTo identify the prognostic factors related to tumor recurrence and progression in Korean patients with non-muscle-invasive bladder cancer (NMIBC).Materials and MethodsData were collected and analyzed for 2412 NMIBC patients from 15 centers who were initially diagnosed after transurethral resection of bladder tumor (TURBT) from January 2006 to December 2010. Using univariable and multivariable Cox proportional hazards models, the prognostic value of each variable was evaluated for the time to first recurrence and progression.ResultsWith a median follow-up duration of 37 months, 866 patients (35.9%) experienced recurrence, and 137 (5.7%) experienced progression. Patients with recurrence had a median time to the first recurrence of 10 months. Multivariable analysis conducted in all patients revealed that preoperative positive urine cytology (PUC) was independently associated with worse recurrence-free survival [RFS; hazard ratio (HR) 1.56; p<0.001], and progression-free survival (PFS; HR 1.56; p=0.037). In particular, on multivariable analysis conducted for the high-risk group (T1 tumor/high-grade Ta tumor/carcinoma in situ), preoperative PUC was an independent predictor of worse RFS (HR 1.73; p<0.001) and PFS (HR 1.96; p=0.006). On multivariable analysis in patients with T1 high-grade (T1HG) cancer (n=684), better RFS (HR 0.75; p=0.033) and PFS (HR 0.33; p<0.001) were observed in association with the administration of intravesical Bacillus Calmette-Guérin (BCG) induction therapy.ConclusionA preoperative PUC result may adversely affect RFS and PFS, particularly in high-risk NMIBC patients. Of particular note, intravesical BCG induction therapy should be administered as an adjunct to TURBT in order to improve RFS and PFS in patients with T1HG cancer.

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Tumor size and T stage correlate independently with recurrence and progression in high-risk non-muscle-invasive bladder cancer patients treated with adjuvant BCG

Cited by 17 publications

References 18 publications

Squamous differentiation in pT1 bladder urothelial carcinoma predicts poor response for intravesical chemotherapy

Squamous differentiation in pT1 bladder urothelial carcinoma predicts poor response for intravesical chemotherapy

Treatment of non-muscle invasive bladder cancer with Bacillus Calmette–Guerin (BCG): Biological markers and simulation studies

Prognostic Factors for Recurrence and Progression in Korean Non-Muscle-Invasive Bladder Cancer Patients: A Retrospective, Multi-Institutional Study

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