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).
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.
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.
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.
World journal of urology. 2020 Feb 15 [Epub ahead of print]
Beppe Calò, Ugo Falagario, Francesca Sanguedolce, Alessandro Veccia, Marco Chirico, Emanuel Carvalho-Diaz, Paulo Mota, Estêvão Lima, Riccardo Autorino, Giuseppe Carrieri, Luigi Cormio
Department of Urology and Renal Transplantation, University of Foggia, Foggia, Italy. ., Department of Urology and Renal Transplantation, University of Foggia, Foggia, Italy., Department of Pathology, University of Foggia, Foggia, Italy., Division of Urology, Department of Surgery, VCU Health, Richmond, VA, USA., Department of CUF Urology and Service of Urology, Hospital of Braga, Braga, Portugal.