Portal de Periódicos da CAPES

Dynamic Prognostication Using Conditional Recurrence and Progression Estimates for Patients with Nonmuscle Invasive Bladder Cancer

2016; Lippincott Williams & Wilkins; Volume: 196; Issue: 1 Linguagem: Inglês

10.1016/j.juro.2016.01.102

1527-3792

Carmen V. Leitner, Ines Ana Ederer, Michela de Martino, Sebastian Hofbauer, Ilaria Lucca, Aurélie Mbeutcha, Romain Mathiéu, Andrea Haitel, Martin Susani, Shahrokh F. Shariat, Tobias Klatte,

Urinary Bladder and Prostate Research

No AccessJournal of UrologyAdult Urology1 Jul 2016Dynamic Prognostication Using Conditional Recurrence and Progression Estimates for Patients with Nonmuscle Invasive Bladder Cancer Carmen V. Leitner, Ines A. Ederer, Michela de Martino, Sebastian L. Hofbauer, Ilaria Lucca, Aurélie Mbeutcha, Romain Mathieu, Andrea Haitel, Martin Susani, Shahrokh F. Shariat, and Tobias Klatte Carmen V. LeitnerCarmen V. Leitner Department of Urology, Medical University of Vienna, Vienna General Hospital, Vienna, Austria More articles by this author , Ines A. EdererInes A. Ederer Department of Urology, Medical University of Vienna, Vienna General Hospital, Vienna, Austria More articles by this author , Michela de MartinoMichela de Martino Department of Urology, Medical University of Vienna, Vienna General Hospital, Vienna, Austria More articles by this author , Sebastian L. HofbauerSebastian L. Hofbauer Department of Urology, Medical University of Vienna, Vienna General Hospital, Vienna, Austria More articles by this author , Ilaria LuccaIlaria Lucca Department of Urology, Medical University of Vienna, Vienna General Hospital, Vienna, Austria More articles by this author , Aurélie MbeutchaAurélie Mbeutcha Department of Urology, Medical University of Vienna, Vienna General Hospital, Vienna, Austria More articles by this author , Romain MathieuRomain Mathieu Department of Urology, Medical University of Vienna, Vienna General Hospital, Vienna, Austria More articles by this author , Andrea HaitelAndrea Haitel Clinical Institute of Pathology, Medical University of Vienna, Vienna General Hospital, Vienna, Austria More articles by this author , Martin SusaniMartin Susani Clinical Institute of Pathology, Medical University of Vienna, Vienna General Hospital, Vienna, Austria More articles by this author , Shahrokh F. ShariatShahrokh F. Shariat Department of Urology, Medical University of Vienna, Vienna General Hospital, Vienna, Austria Department of Urology, University of Texas Southwestern Medical Center, Dallas, Texas Department of Urology, Weill Cornell Medical College, New York-Presbyterian Hospital, New York, New York More articles by this author , and Tobias KlatteTobias Klatte Department of Urology, Medical University of Vienna, Vienna General Hospital, Vienna, Austria More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2016.01.102AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: Conditional estimates provide a dynamic prediction of outcomes but to our knowledge there are no data on nonmuscle invasive bladder cancer. We assessed changes in conditional recurrence and progression rates after transurethral resection of the bladder and explored the prognostic impact of established factors and risk groups with time. Materials and Methods: We retrospectively analyzed data on 1,292 consecutive patients with newly diagnosed Ta/T1 bladder cancer who underwent transurethral resection of the bladder. Study end points were time to first recurrence and time to progression. Results: The 2-year recurrence rate at baseline was 36%, which improved as a function of the time that patients were free of disease recurrence. After 6, 12, 24, 36 and 48 months the 2-year conditional recurrence rate improved to 31% (14% improvement vs baseline), 22% (39% improvement), 16% (56% improvement), 13% (64% improvement) and 11% (69% improvement), respectively. Comparably, conditional progression rates improved with increasing followup, although relative differences were less distinct. The prognostic impact of established factors and nonmuscle invasive bladder cancer risk groups progressively decreased with time and finally disappeared. However, bacillus Calmette-Guérin had a protective effect on progression even after 3 years. We provide tables with dynamic prognostic information at all analyzed time points. Conclusions: In patients with primary Ta/T1 bladder cancer recurrence and progression rates improve with time. The prognostic impact of established factors and risk groups decreases and finally disappears. The effect of bacillus Calmette-Guérin on progression is long-lasting. Conditional outcome estimates may improve patient counseling and individualize surveillance planning. References 1 : Cancer incidence and mortality worldwide: sources, methods and major patterns in GLOBOCAN 2012. Int J Cancer2015; 136: E359. Google Scholar 2 : Bladder cancer mortality in the United States: a geographic and temporal analysis of socioeconomic and environmental factors. J Urol2015; 195: 290. Google Scholar 3 : Global estimates of cancer prevalence for 27 sites in the adult population in 2008. Int J Cancer2013; 132: 1133. Google Scholar 4 : Histopathology and prognosis of de novo bladder tumors following solid organ transplantation. World J Urol2015; 33: 2087. Google Scholar 5 : EAU guidelines on non-muscle-invasive urothelial carcinoma of the bladder: update 2013. Eur Urol2013; 64: 639. Google Scholar 6 : Predicting recurrence and progression in individual patients with stage Ta T1 bladder cancer using EORTC risk tables: a combined analysis of 2596 patients from seven EORTC trials. Eur Urol2006; 49: 466. Google Scholar 7 : The health economics of bladder cancer: an updated review of the published literature. Pharmacoeconomics2014; 32: 1093. Google Scholar 8 : Conditional survival after radical cystectomy for bladder cancer: evidence for a patient changing risk profile over time. Eur Urol2014; 66: 361. Google Scholar 9 : Dynamic prognostication using conditional survival estimates. Cancer2013; 119: 3589. Google Scholar 10 : Conditional survival for longer-term survivors from 2000-2004 using population-based cancer registry data in Osaka, Japan. BMC Cancer2013; 13: 304. Google Scholar 11 : Conditional survival of cancer patients: an Australian perspective. BMC Cancer2012; 12: 460. Google Scholar 12 : Clinical relevance of conditional survival of cancer patients in Europe: age-specific analyses of 13 cancers. J Clin Oncol2010; 28: 2520. Google Scholar 13 : Conditional survival after nephrectomy for renal cell carcinoma (RCC): changes in future survival probability over time. BJU Int2013; 111: E283. Google Scholar 14 : The key role of time in predicting progression-free survival in patients with renal cell carcinoma treated with partial or radical nephrectomy: conditional survival analysis. Urol Oncol2014; 32: 43.e9. Google Scholar 15 : Conditional survival of patients with metastatic renal-cell carcinoma treated with VEGF-targeted therapy: a population-based study. Lancet Oncol2012; 13: 927. Google Scholar 16 : Conditional survival predictions after surgery for patients with penile carcinoma. Cancer2011; 117: 3723. Google Scholar 17 : Conditional survival of patients with urothelial carcinoma of the urinary bladder treated with radical cystectomy. Eur J Cancer2012; 48: 1503. Google Scholar 18 : Urinary bladder. In: AJCC Cancer Staging Manual, 7th ed. New York: Springer2010: 497. Google Scholar 19 : Accuracy of the EORTC risk tables and of the CUETO scoring model to predict outcomes in non-muscle-invasive urothelial carcinoma of the bladder. Br J Cancer2013; 109: 1460. Google Scholar 20 : Getting the most out of bacillus Calmette-Guérin for treatment of bladder cancer. J Urol2016; 195: 7. Link, Google Scholar 21 : Randomized controlled study of the efficacy, safety and quality of life of low-dose bacillus Calmette-Guérin instillation therapy for non-muscle-invasive bladder cancer. J Urol2016; 195: 41. Link, Google Scholar 22 : Conditional survival after radical nephroureterectomy for upper tract carcinoma. Eur Urol2015; 67: 803. Google Scholar 23 : Systematic review and individual patient data meta-analysis of randomized trials comparing a single immediate instillation of chemotherapy after transurethral resection with transurethral resection alone in patients with stage pTa-pT1 urothelial carcinoma: which patients benefit from the instillation?. Eur Urol2016; 69: 231. Google Scholar 24 : Economic and humanistic consequences of preventable bladder tumor recurrences in nonmuscle invasive bladder cancer cases. J Urol2012; 188: 2114. Link, Google Scholar © 2016 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetailsCited byChang S (2018) Re: Analysis of T1 Bladder Cancer on Biopsy and Transurethral Resection Specimens: Comparison and Ranking of T1 Quantification Approaches to Predict Progression to Muscularis Propria InvasionJournal of Urology, VOL. 200, NO. 5, (942-943), Online publication date: 1-Nov-2018.Shigeta K, Kikuchi E, Hagiwara M, Ando T, Mizuno R, Abe T, Mikami S, Miyajima A, Nakagawa K and Oya M (2017) The Conditional Survival with Time of Intravesical Recurrence of Upper Tract Urothelial CarcinomaJournal of Urology, VOL. 198, NO. 6, (1278-1285), Online publication date: 1-Dec-2017. Volume 196Issue 1July 2016Page: 46-51Supplementary Materials Advertisement Copyright & Permissions© 2016 by American Urological Association Education and Research, Inc.KeywordsrecurrenceMycobacterium bovisdisease progressionurinary bladder neoplasmsmitomycinMetricsAuthor Information Carmen V. Leitner Department of Urology, Medical University of Vienna, Vienna General Hospital, Vienna, Austria More articles by this author Ines A. Ederer Department of Urology, Medical University of Vienna, Vienna General Hospital, Vienna, Austria More articles by this author Michela de Martino Department of Urology, Medical University of Vienna, Vienna General Hospital, Vienna, Austria More articles by this author Sebastian L. Hofbauer Department of Urology, Medical University of Vienna, Vienna General Hospital, Vienna, Austria More articles by this author Ilaria Lucca Department of Urology, Medical University of Vienna, Vienna General Hospital, Vienna, Austria More articles by this author Aurélie Mbeutcha Department of Urology, Medical University of Vienna, Vienna General Hospital, Vienna, Austria More articles by this author Romain Mathieu Department of Urology, Medical University of Vienna, Vienna General Hospital, Vienna, Austria More articles by this author Andrea Haitel Clinical Institute of Pathology, Medical University of Vienna, Vienna General Hospital, Vienna, Austria More articles by this author Martin Susani Clinical Institute of Pathology, Medical University of Vienna, Vienna General Hospital, Vienna, Austria More articles by this author Shahrokh F. Shariat Department of Urology, Medical University of Vienna, Vienna General Hospital, Vienna, Austria Department of Urology, University of Texas Southwestern Medical Center, Dallas, Texas Department of Urology, Weill Cornell Medical College, New York-Presbyterian Hospital, New York, New York More articles by this author Tobias Klatte Department of Urology, Medical University of Vienna, Vienna General Hospital, Vienna, Austria More articles by this author Expand All Advertisement PDF downloadLoading ...