Previous Bladder Cancer History in Patients with High-Risk, Non-muscle-invasive Bladder Cancer Correlates with Recurrence and Progression: Implications of Natural History.
- Author:
Lampros P MITRAKAS
1
;
Ioannis V ZACHOS
;
Vassileios P TZORTZIS
;
Stavros A GRAVAS
;
Erasmia C ROUKA
;
Konstantinos I DIMITROPOULOS
;
Gerasimos P VANDOROS
;
Anastasios D KARATZAS
;
Michael D MELEKOS
;
Athanasios G PAPAVASSILIOU
Author Information
- Publication Type:Original Article
- Keywords: High-risk; Non-muscle-invasive bladder cancer; Previous bladder cancer history; Recurrence; Disease progression
- MeSH: Bacillus; Carcinoma in Situ; Disease Progression; Disease-Free Survival; Humans; Logistic Models; Mycobacterium bovis; Natural History*; Recurrence*; Urinary Bladder Neoplasms*
- From:Cancer Research and Treatment 2015;47(3):495-500
- CountryRepublic of Korea
- Language:English
- Abstract: PURPOSE: The purpose of this study was to assess the correlation of previous bladder cancer history with the recurrence and progression of patients with high-risk non-muscle-invasive bladder cancer treated with adjuvant Bacillus Calmette-Guerin (BCG) and to evaluate their natural history. MATERIALS AND METHODS: Patients were divided into two groups based on the existence of previous bladder cancer (primary, non-primary). A logistic regression analysis was used to identify the possible differences in the probabilities of recurrence and progression with respect to tumor history, while potential differences due to gender, tumor size (> 3 cm, < 3 cm), stage (pTa, T1), concomitant carcinoma in situ (pTis) and number of tumors (single, multiple) were also assessed. Univariate and multivariate models were employed. In addition, Kaplan-Meier survival analysis was used to compare recurrence- and progression-free survival between the groups. RESULTS: A total of 192 patients were included (144 with primary and 48 with non-primary tumors). The rates of recurrence and progression for patients with primary tumors were 27.8% and 12.5%, respectively. The corresponding percentages for patients with non-primary tumors were 77.1% and 33.3%, respectively. The latter group of patients displayed significantly higher probabilities of recurrence (p=0.000; 95% confidence interval [CI], 4.067 to 18.804) and progression (p=0.002; 95% CI, 1.609 to 7.614) in a univariate logistic regression analysis. Previous bladder cancer history remained significant in the multivariate model accounting for history, age, gender, tumor size , number of tumors, stage and concomitant pTis (p=0.000; 95% CI, 4.367 to 21.924 and p=0.002; 95% CI, 1.611 to 8.182 for recurrence and progression respectively). Kaplan-Meier curves revealed that the non-primary group hadreduced progression- and recurrence-free survival. CONCLUSION: Previous non-muscle-invasive bladder cancer history correlates significantly with recurrence and progression in patients with high-risk non-muscle-invasive disease treated with adjuvant BCG.
