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Impact of time to second transurethral resection on oncological outcomes of patients with high-grade T1 bladder cancer treated with intravesical Bacillus Calmette–Guerin

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Abstract

Purpose

To determine the impact of time to restaging transurethral resection (Re-TUR) on recurrence-free survival (RFS), progression-free survival (PFS), and cancer specific survival (CSS) of patients with high-grade T1 bladder cancer (BC) treated with intravesical Bacillus Calmette–Guerin (BCG).

Materials and patients

Our prospectively maintained NMIBC databases were queried to identify patients with high-grade T1 BC who underwent Re-TUR before receiving intravesical BCG treatment (induction + 1-year maintenance). Patients were divided into three groups based on time to Re-TUR (group A: ≤ 6 weeks; group B: > 6–12 weeks; group C: > 12–18 weeks). Kaplan–Meier plots were used to estimate differences in RFS, PFS, and CSS. Multivariate Cox regression analysis was used to assess the impact of time to Re-TUR on oncological outcomes.

Results

Overall, 269 high-grade T1 BC patients were eligible for the analysis. Nineteen (7.1%) had concomitant CIS. Median follow-up was 49.3 (IQR 25–65) months. Kaplan–Meier plots showed no differences in RFS, PFS, and CSS between the three groups. Multivariate Cox regression analysis showed that Group B had a slightly better RFS, while the other outcomes were not affected by time to Re-TUR.

Conclusions

This is the first study testing the role of time to Re-TUR in a homogeneous population of patients with high-grade T1 BC who received complete BCG treatment. The study challenged the concept the sooner the Re-TUR the better, since time to Re-TUR did not significantly affect oncological outcomes.

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Authors and Affiliations

  1. Department of Urology and Renal Transplantation, University of Foggia, Foggia, Italy

    Beppe Calò, Ugo Falagario, Marco Chirico, Giuseppe Carrieri & Luigi Cormio

  2. Department of CUF Urology and Service of Urology, Hospital of Braga, Braga, Portugal

    Beppe Calò, Emanuel Carvalho-Diaz, Paulo Mota & Estêvão Lima

  3. Department of Pathology, University of Foggia, Foggia, Italy

    Francesca Sanguedolce

  4. Division of Urology, Department of Surgery, VCU Health, Richmond, VA, USA

    Alessandro Veccia & Riccardo Autorino

Authors
  1. Beppe Calò
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  2. Ugo Falagario
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  3. Francesca Sanguedolce
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  4. Alessandro Veccia
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  5. Marco Chirico
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  6. Emanuel Carvalho-Diaz
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  7. Paulo Mota
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  8. Estêvão Lima
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  9. Riccardo Autorino
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  10. Giuseppe Carrieri
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  11. Luigi Cormio
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Contributions

BC: protocol and project development; data collection, and manuscript writing. UGF: data management and data analysis. FS: manuscript writing and editing. AV: data management and data analysis. MC: project development, data collection. EC-D: protocol and project development; manuscript editing. PM: project development; manuscript editing. EL: protocol development, manuscript editing. RA: data management and manuscript editing. GC: manuscript editing. LC: protocol development, manuscript writing and editing.

Corresponding author

Correspondence to Beppe Calò.

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The authors declare no conflicts of interest related to this work.

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Informed consent was obtained from all individual participants included in the study.

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Calò, B., Falagario, U., Sanguedolce, F. et al. Impact of time to second transurethral resection on oncological outcomes of patients with high-grade T1 bladder cancer treated with intravesical Bacillus Calmette–Guerin. World J Urol 38, 3161–3167 (2020). https://doi.org/10.1007/s00345-020-03108-z

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  • DOI: https://doi.org/10.1007/s00345-020-03108-z

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