Prognostic Factors for Recurrence and Progression in Korean Non-Muscle-Invasive Bladder Cancer Patients: A Retrospective, Multi-Institutional Study.
10.3349/ymj.2016.57.4.855
- Author:
Hyung Suk KIM
1
;
Ja Hyeon KU
;
Se Joong KIM
;
Sung Joon HONG
;
Sung Hoo HONG
;
Hong Sup KIM
;
Tae Gyun KWON
;
Jin Seon CHO
;
Seong Soo JEON
;
Kwan Joong JOO
;
Han Jong AHN
;
Hong Seok PARK
;
Do Hwan SEONG
;
Dong Deuk KWON
;
Hyung Jin KIM
;
Jae Sung LIM
;
Hyung Lae LEE
Author Information
1. Department of Urology, Dongguk University Ilsan Medical Center, Goyang, Korea.
- Publication Type:Multicenter Study ; Original Article
- Keywords:
Urinary bladder neoplasm;
recurrence;
disease progression;
prognosis
- MeSH:
Aged;
Carcinoma in Situ/*mortality/*pathology/therapy;
Disease Progression;
Disease-Free Survival;
Female;
Humans;
Male;
Middle Aged;
Neoplasm Recurrence, Local/*mortality/*pathology;
Prognosis;
Proportional Hazards Models;
Republic of Korea;
Retrospective Studies;
Risk;
Urinary Bladder Neoplasms/*mortality/*pathology/therapy
- From:Yonsei Medical Journal
2016;57(4):855-864
- CountryRepublic of Korea
- Language:English
-
Abstract:
PURPOSE: To identify the prognostic factors related to tumor recurrence and progression in Korean patients with non-muscle-invasive bladder cancer (NMIBC). MATERIALS AND METHODS: Data 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. RESULTS: With 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. CONCLUSION: A 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.
