Otto, Wolfgang and van Rhijn, Bas W. G. and Breyer, Johannes and Bertz, Simone and Eckstein, Markus and Mayr, Roman and Lausenmeyer, Eva M. and Denzinger, Stefan and Burger, Maximilian and Hartmann, Arndt (2018) Infiltrative lamina propria invasion pattern as an independent predictor for cancer-specific and overall survival of instillation treatment-naive stageT1 high-grade urothelial bladder cancer. INTERNATIONAL JOURNAL OF UROLOGY, 25 (5). pp. 442-449. ISSN 0919-8172, 1442-2042
Full text not available from this repository. (Request a copy)Abstract
ObjectivesTo investigate established prognostic factors and relatively new histopathological tumor characteristics including metric substage and lamina propria invasion patterns in a large series of T1 high-grade non-muscle-invasive bladder cancer. MethodsBetween 1989 and 2012, 322 patients with initial stageT1 high-grade bladder cancer underwent transurethral resection, followed by re-transurethral resection and a conservative approach with follow-up regime alone or instillation treatment. Transurethral resection specimens were reassessed by two experienced urological pathologists for tumor grade according to the World Health Organization 1973 classification, metric T1 substage, lamina propria invasion pattern and associated carcinoma insitu. The median follow-up period was 42months (interquartile range 25-72months). In addition to Kaplan-Meier analyses, uni- and multivariable Cox regression analyses were used to compare progression-free survival, cancer-specific survival and overall survival for the studied parameters comparing two subcohorts. ResultsWhile in patients after instillation treatment no examined feature was shown as an independent predictor for prognosis, there were predictive histopathological features in multivariable Cox regression analyses in instillation treatment-naive patients: associated carcinoma insitu (hazard ratio 2.278, 95% confidence interval 1.119-4.634, P=0.023) and World Health Organization 1973 grade3 (hazard ratio 2.950, 95% confidence interval 1.021-8.536, P=0.046) for worse progression-free survival, infiltrative lamina propria tumor pattern for worse cancer-specific survival (hazard ratio 2.369, 95% confidence interval 1.034-5.429, P=0.042) and overall survival (hazard ratio 1.049, 95% confidence interval 1.024-1.075, P=0.001). ConclusionsThe results of the present T1 high-grade bladder cancer series suggest that lamina propria invasion pattern is a promising parameter to predict the prognosis of T1 high-grade bladder cancer in an instillation treatment-naive subcohort. Prospective multicenter evaluations are warranted. The need for instillation treatment in T1 high-grade bladder cancer is clearly demanded.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | SQUAMOUS-CELL CARCINOMA; PROGNOSTIC-SIGNIFICANCE; RISK STRATIFICATION; TUMOR; CLASSIFICATION; MULTICENTER; PROGRESSION; PROPOSAL; DEPTH; SIZE; instillation treatment; prognosis; stageT1 high-grade; tumor growth pattern; urothelial bladder cancer |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Urologie |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 23 Mar 2020 12:39 |
| Last Modified: | 06 Apr 2020 05:16 |
| URI: | https://pred.uni-regensburg.de/id/eprint/14662 |
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