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The Optimal Timing of Restaging Resection before Introduction of Bacillus Calmette-Guerin Immunotherapy in Patients with High-Risk Non-Muscle-Invasive Bladder Cancer
- Source :
- Urologia Internationalis. 102:60-68
- Publication Year :
- 2018
- Publisher :
- S. Karger AG, 2018.
-
Abstract
- Introduction: The study aimed to analyze the influence of restaging transurethral resection of bladder tumor (reTURB) timing on outcomes in patients receiving Bacillus Calmette-Guerin (BCG) immunotherapy. Material and Methods: This retrospective study enrolled 491 patients with bladder cancer receiving BCG intravesical therapy between 1998 and 2016. All patients were followed up for at least 12 months and received at least 7 BCG instillations. The patients were analyzed in terms of recurrence free, progression free, and cancer specific survival (CSS). Results: Median follow-up was 57 months (12–257 months). The risk for all analyzed clinical events was higher in patients who underwent reTURB after 6 weeks from primary TURB. After the change point of 57 days after primary resection, further delay was not associated with increased risk of recurrence and progression. The time limit for CSS was 76 days. With every 1 more day of time interval between TURB and reTURB, the risk of each clinical event in follow-up increased by 4%. Conclusions: There is no benefit of the reTURB performed after 8 weeks from primary TURB. Optimal timing of reTURB is from 2 to 6 weeks after initial TURB. However, even within this time frame, the sooner the procedure is performed, the risk of recurrence, progression, or cancer-specific death is lower.
- Subjects :
- Male
Risk
medicine.medical_specialty
Time Factors
Urology
medicine.medical_treatment
030232 urology & nephrology
Disease-Free Survival
Cancer specific survival
Resection
03 medical and health sciences
0302 clinical medicine
medicine
Humans
Neoplasm Invasiveness
In patient
Aged
Neoplasm Staging
Retrospective Studies
Bladder cancer
business.industry
Retrospective cohort study
Immunotherapy
Middle Aged
medicine.disease
Increased risk
Urinary Bladder Neoplasms
030220 oncology & carcinogenesis
BCG Vaccine
Disease Progression
Female
Neoplasm Recurrence, Local
Non muscle invasive
business
Follow-Up Studies
Subjects
Details
- ISSN :
- 14230399 and 00421138
- Volume :
- 102
- Database :
- OpenAIRE
- Journal :
- Urologia Internationalis
- Accession number :
- edsair.doi.dedup.....303185e27a3edfd214d0c3b73b308da0