Breyer, J. and Otto, W. and Hartmann, A. and Bumes, B. and Bruendl, J. and Gierth, M. and Bertz, S. and Denzinger, S. and Burger, M. and Lausenmeyer, E. M. (2015) Anamnesis, Pathological Assessment, Therapeutic Features and Course of Disease: Retrospective Study on Clinical-Based Factors for Prediction of Cancer-Specific Survival of 378 Patients with Stage pT1 Urothelial Bladder Carcinoma. AKTUELLE UROLOGIE, 46 (3). pp. 221-226. ISSN 0001-7868, 1438-8820
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Background: Urothelial carcinoma of the bladder (UBC) at stage pT1 is a heterogenous disease. Established criteria for prognosis prediction are not suitable for every patient. Choosing the right therapeutic strategy for the individual patient thus remains a challenge. The aim of the present study was to identify clinical parameters regarding cancer-specific survival (CSS) in patients with pT1 UBC. Materials and Methods: A retrospective analysis of clinical parameters of all patients with a pT1 UBC between 1989 and 2012 from a single centre was performed. Treatment consisted of transurethral resection, second resection followed by initially bladder sparing treatment. Anamnestic data, histopathological reports and clinical course were assessed with CSS being defined as primary endpoint. Kaplan-Meier analysis, uniand multivariate analysis were performed using SPSS (Version 22, IBM). Results: 378 patients (78 % male, median age 72 years) were included, median follow-up was 35 months. Pathological stage pT1G3 (66 vs. 91 %, p < 0.001), lack of instillation therapy (66 vs. 83 %, p < 0.001), presence of a second malignoma (41 vs. 77 %, p = 0,004), diagnosis after 2000 (75 vs. 76 %, p = 0,018) and tumour progress (42 vs. 85 %, p < 0.001) were associated with a worse CSS in univariate and Kaplan-Meier analysis. Multivariate analysis revealed the presence of a second malignoma (HR 2.267; CI 95 % 1.143-4.497, p = 0.019), pathological stage pT1G3 at initial diagnosis (HR 4.567; CI 95 % 2.040-10.22, p < 0.001) and tumour progress (HR 3.742; CI 95 % 1.544-9.069, p = 0.003) as independent negative predictors of CSS. Instillation therapy was a prognostic factor for improved CSS (HR 0.368; CI 95 % 0.212-0.638, p < 0.001). Conclusion: The present study identified the presence of a second malignoma, pathological stage pT1G3 and tumour progress as negative predictive factors for CSS. Maintenance instillation therapy after reresection was associated with an improved CSS.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | BACILLUS-CALMETTE-GUERIN; EORTC RISK TABLES; TRANSITIONAL-CELL CARCINOMA; EUROPEAN ORGANIZATION; EXTERNAL VALIDATION; IN-SITU; PROGRESSION; RECURRENCE; T1; MORTALITY; urothelial bladder carcinoma; stage pT1; transurethral resection; WHO 1973 grading; instillation therapy |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Urologie |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 18 Jul 2019 09:37 |
| Last Modified: | 18 Jul 2019 09:37 |
| URI: | https://pred.uni-regensburg.de/id/eprint/5533 |
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