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Prognostic Factors for Recurrence and Progression in Korean Non-Muscle-Invasive Bladder Cancer Patients: A Retrospective, Multi-Institutional Study
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...
Autores principales: | , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Yonsei University College of Medicine
2016
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4951460/ https://www.ncbi.nlm.nih.gov/pubmed/27189277 http://dx.doi.org/10.3349/ymj.2016.57.4.855 |
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author | Kim, Hyung Suk Ku, Ja Hyeon Kim, Se Joong Hong, Sung Joon Hong, Sung Hoo Kim, Hong Sup Kwon, Tae Gyun Cho, Jin Seon Jeon, Seong Soo Joo, Kwan Joong Ahn, Han Jong Park, Hong Seok Seong, Do Hwan Kwon, Dong Deuk Kim, Hyung Jin Lim, Jae Sung Lee, Hyung-Lae |
author_facet | Kim, Hyung Suk Ku, Ja Hyeon Kim, Se Joong Hong, Sung Joon Hong, Sung Hoo Kim, Hong Sup Kwon, Tae Gyun Cho, Jin Seon Jeon, Seong Soo Joo, Kwan Joong Ahn, Han Jong Park, Hong Seok Seong, Do Hwan Kwon, Dong Deuk Kim, Hyung Jin Lim, Jae Sung Lee, Hyung-Lae |
author_sort | Kim, Hyung Suk |
collection | PubMed |
description | 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. |
format | Online Article Text |
id | pubmed-4951460 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2016 |
publisher | Yonsei University College of Medicine |
record_format | MEDLINE/PubMed |
spelling | pubmed-49514602016-07-20 Prognostic Factors for Recurrence and Progression in Korean Non-Muscle-Invasive Bladder Cancer Patients: A Retrospective, Multi-Institutional Study Kim, Hyung Suk Ku, Ja Hyeon Kim, Se Joong Hong, Sung Joon Hong, Sung Hoo Kim, Hong Sup Kwon, Tae Gyun Cho, Jin Seon Jeon, Seong Soo Joo, Kwan Joong Ahn, Han Jong Park, Hong Seok Seong, Do Hwan Kwon, Dong Deuk Kim, Hyung Jin Lim, Jae Sung Lee, Hyung-Lae Yonsei Med J Original Article 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. Yonsei University College of Medicine 2016-07-01 2016-05-10 /pmc/articles/PMC4951460/ /pubmed/27189277 http://dx.doi.org/10.3349/ymj.2016.57.4.855 Text en © Copyright: Yonsei University College of Medicine 2016 http://creativecommons.org/licenses/by-nc/3.0/ 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 Kim, Hyung Suk Ku, Ja Hyeon Kim, Se Joong Hong, Sung Joon Hong, Sung Hoo Kim, Hong Sup Kwon, Tae Gyun Cho, Jin Seon Jeon, Seong Soo Joo, Kwan Joong Ahn, Han Jong Park, Hong Seok Seong, Do Hwan Kwon, Dong Deuk Kim, Hyung Jin Lim, Jae Sung Lee, Hyung-Lae Prognostic Factors for Recurrence and Progression in Korean Non-Muscle-Invasive Bladder Cancer Patients: A Retrospective, Multi-Institutional Study |
title | Prognostic Factors for Recurrence and Progression in Korean Non-Muscle-Invasive Bladder Cancer Patients: A Retrospective, Multi-Institutional Study |
title_full | Prognostic Factors for Recurrence and Progression in Korean Non-Muscle-Invasive Bladder Cancer Patients: A Retrospective, Multi-Institutional Study |
title_fullStr | Prognostic Factors for Recurrence and Progression in Korean Non-Muscle-Invasive Bladder Cancer Patients: A Retrospective, Multi-Institutional Study |
title_full_unstemmed | Prognostic Factors for Recurrence and Progression in Korean Non-Muscle-Invasive Bladder Cancer Patients: A Retrospective, Multi-Institutional Study |
title_short | Prognostic Factors for Recurrence and Progression in Korean Non-Muscle-Invasive Bladder Cancer Patients: A Retrospective, Multi-Institutional Study |
title_sort | prognostic factors for recurrence and progression in korean non-muscle-invasive bladder cancer patients: a retrospective, multi-institutional study |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4951460/ https://www.ncbi.nlm.nih.gov/pubmed/27189277 http://dx.doi.org/10.3349/ymj.2016.57.4.855 |
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