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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

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–Guérin (BCG) and to evaluate their natural history. MATERIALS...

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Autores principales: Mitrakas, Lampros P., Zachos, Ioannis V., Tzortzis, Vassileios P., Gravas, Stavros A., Rouka, Erasmia C., Dimitropoulos, Konstantinos I., Vandoros, Gerasimos P., Karatzas, Anastasios D., Melekos, Michael D., Papavassiliou, Athanasios G.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Korean Cancer Association 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4506110/
https://www.ncbi.nlm.nih.gov/pubmed/25483745
http://dx.doi.org/10.4143/crt.2014.050
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author Mitrakas, Lampros P.
Zachos, Ioannis V.
Tzortzis, Vassileios P.
Gravas, Stavros A.
Rouka, Erasmia C.
Dimitropoulos, Konstantinos I.
Vandoros, Gerasimos P.
Karatzas, Anastasios D.
Melekos, Michael D.
Papavassiliou, Athanasios G.
author_facet Mitrakas, Lampros P.
Zachos, Ioannis V.
Tzortzis, Vassileios P.
Gravas, Stavros A.
Rouka, Erasmia C.
Dimitropoulos, Konstantinos I.
Vandoros, Gerasimos P.
Karatzas, Anastasios D.
Melekos, Michael D.
Papavassiliou, Athanasios G.
author_sort Mitrakas, Lampros P.
collection PubMed
description 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–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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spelling pubmed-45061102015-07-21 Previous Bladder Cancer History in Patients with High-Risk, Non–muscle-invasive Bladder Cancer Correlates with Recurrence and Progression: Implications of Natural History Mitrakas, Lampros P. Zachos, Ioannis V. Tzortzis, Vassileios P. Gravas, Stavros A. Rouka, Erasmia C. Dimitropoulos, Konstantinos I. Vandoros, Gerasimos P. Karatzas, Anastasios D. Melekos, Michael D. Papavassiliou, Athanasios G. Cancer Res Treat Original Article 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–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. Korean Cancer Association 2015-07 2014-09-11 /pmc/articles/PMC4506110/ /pubmed/25483745 http://dx.doi.org/10.4143/crt.2014.050 Text en Copyright © 2015 by the Korean Cancer Association This is an Open-Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Mitrakas, Lampros P.
Zachos, Ioannis V.
Tzortzis, Vassileios P.
Gravas, Stavros A.
Rouka, Erasmia C.
Dimitropoulos, Konstantinos I.
Vandoros, Gerasimos P.
Karatzas, Anastasios D.
Melekos, Michael D.
Papavassiliou, Athanasios G.
Previous Bladder Cancer History in Patients with High-Risk, Non–muscle-invasive Bladder Cancer Correlates with Recurrence and Progression: Implications of Natural History
title Previous Bladder Cancer History in Patients with High-Risk, Non–muscle-invasive Bladder Cancer Correlates with Recurrence and Progression: Implications of Natural History
title_full Previous Bladder Cancer History in Patients with High-Risk, Non–muscle-invasive Bladder Cancer Correlates with Recurrence and Progression: Implications of Natural History
title_fullStr Previous Bladder Cancer History in Patients with High-Risk, Non–muscle-invasive Bladder Cancer Correlates with Recurrence and Progression: Implications of Natural History
title_full_unstemmed Previous Bladder Cancer History in Patients with High-Risk, Non–muscle-invasive Bladder Cancer Correlates with Recurrence and Progression: Implications of Natural History
title_short Previous Bladder Cancer History in Patients with High-Risk, Non–muscle-invasive Bladder Cancer Correlates with Recurrence and Progression: Implications of Natural History
title_sort previous bladder cancer history in patients with high-risk, non–muscle-invasive bladder cancer correlates with recurrence and progression: implications of natural history
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4506110/
https://www.ncbi.nlm.nih.gov/pubmed/25483745
http://dx.doi.org/10.4143/crt.2014.050
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