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Previous Bladder Cancer History in Patients with High-Risk, Non–muscle-invasive Bladder Cancer Correlates with Recurrence and Progression: Implications of Natural History
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Lampros P. Mitrakas, 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
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Cancer Res Treat. 2015;47(3):495-500. Published online September 11, 2014
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DOI: https://doi.org/10.4143/crt.2014.050
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Abstract
PDFPubReaderePub
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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–Guérin (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.
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Citations
Citations to this article as recorded by
- Treatment Outcomes of High-Risk Non-Muscle Invasive Bladder Cancer (HR-NMIBC) in Real-World Evidence (RWE) Studies: Systematic Literature Review (SLR)
Mihaela Georgiana Musat, Christina Soeun Kwon, Elizabeth Masters, Slaven Sikirica, Debduth B Pijush, Anna Forsythe ClinicoEconomics and Outcomes Research.2022; Volume 14: 35. CrossRef - Quality of Life and Anxiety in Patients with First Diagnosed Non-Muscle Invasive Bladder Cancer Who Receive Adjuvant Bladder Therapy
Alexandros Vaioulis, Konstantinos Bonotis, Konstantinos Perivoliotis, Yiannis Kiouvrekis, Stavros Gravas, Vasilios Tzortzis, Anastasios Karatzas Bladder Cancer.2021; 7(3): 297. CrossRef - Extensive rhabdomyosarcomatous differentiation in recurrent low-grade urothelial carcinoma of the bladder after transurethral resection: a case report
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