Abstract
OBJECTIVE • To investigate the risk of subsequent tumour recurrence and stage progression in bacillus Calmette-Guérin (BCG)-relapsing non-muscle-invasive bladder cancer, defined as recurrence after achieving a disease-free status for 6 months. PATIENTS AND METHODS • A total of 183 patients with BCGrelapsing tumours were treated with conservative therapy between 1985 and 2008 at our three institutions. • We analysed the association between their clinicopathological parameters and subsequent tumour recurrence or stage progression. RESULTS • Additional induction courses of BCG or anticancer drug (mitomycin C or epirubicin) instillations were performed in 119 patients and 24 patients, respectively. The remaining 40 patients did not undergo any adjuvant therapy. • Multivariate analysis showed that a relapsing tumour with a pathologically high risk (defined as tumours with G3 and/or pT1 and/or concomitant carcinoma in situ ) was a significant risk factor for subsequent tumour recurrence ( P = 0.002; hazard ratio [ HR ] 2.15). Additional BCG instillation significantly decreased the subsequent tumour recurrence rate ( P < 0.001; HR 0.41). • Multivariate analysis also showed that a relapsing tumour with a pathologically high risk was also significantly associated with stage progression ( P < 0.001; HR 8.05). CONCLUSIONS • An additional course of BCG instillation might be effective in patients with BCG-relapsing tumours with pathologically intermediate risk. • Nevertheless, some patients with high-risk pathological features developed subsequent stage progression. Such patients should be followed up closely and counselled on the need for aggressive therapeutic options, such as radical cystectomy.
| Original language | English |
|---|---|
| Journal | BJU International |
| Volume | 110 |
| Issue number | 11 B |
| DOIs | |
| Publication status | Published - 2012 Dec |
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Keywords
- Bacille Calmette-Guérin
- BCG failure
- BCG relapsing
- Non-muscle-invasive bladder cancer
- Stage progression
- Tumour recurrence
ASJC Scopus subject areas
- Urology
Cite this
Risk of subsequent tumour recurrence and stage progression in bacille Calmette-Guérin relapsing non-muscle-invasive bladder cancer. / Matsumoto, Kazuhiro; Kikuchi, Eiji; Shirakawa, Hiroshi; Hayakawa, Nozomi; Tanaka, Nobuyuki; Ninomiya, Akiharu; Miyajima, Akira; Nakamura, So; Oya, Mototsugu.
In: BJU International, Vol. 110, No. 11 B, 12.2012.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Risk of subsequent tumour recurrence and stage progression in bacille Calmette-Guérin relapsing non-muscle-invasive bladder cancer
AU - Matsumoto, Kazuhiro
AU - Kikuchi, Eiji
AU - Shirakawa, Hiroshi
AU - Hayakawa, Nozomi
AU - Tanaka, Nobuyuki
AU - Ninomiya, Akiharu
AU - Miyajima, Akira
AU - Nakamura, So
AU - Oya, Mototsugu
PY - 2012/12
Y1 - 2012/12
N2 - OBJECTIVE • To investigate the risk of subsequent tumour recurrence and stage progression in bacillus Calmette-Guérin (BCG)-relapsing non-muscle-invasive bladder cancer, defined as recurrence after achieving a disease-free status for 6 months. PATIENTS AND METHODS • A total of 183 patients with BCGrelapsing tumours were treated with conservative therapy between 1985 and 2008 at our three institutions. • We analysed the association between their clinicopathological parameters and subsequent tumour recurrence or stage progression. RESULTS • Additional induction courses of BCG or anticancer drug (mitomycin C or epirubicin) instillations were performed in 119 patients and 24 patients, respectively. The remaining 40 patients did not undergo any adjuvant therapy. • Multivariate analysis showed that a relapsing tumour with a pathologically high risk (defined as tumours with G3 and/or pT1 and/or concomitant carcinoma in situ ) was a significant risk factor for subsequent tumour recurrence ( P = 0.002; hazard ratio [ HR ] 2.15). Additional BCG instillation significantly decreased the subsequent tumour recurrence rate ( P < 0.001; HR 0.41). • Multivariate analysis also showed that a relapsing tumour with a pathologically high risk was also significantly associated with stage progression ( P < 0.001; HR 8.05). CONCLUSIONS • An additional course of BCG instillation might be effective in patients with BCG-relapsing tumours with pathologically intermediate risk. • Nevertheless, some patients with high-risk pathological features developed subsequent stage progression. Such patients should be followed up closely and counselled on the need for aggressive therapeutic options, such as radical cystectomy.
AB - OBJECTIVE • To investigate the risk of subsequent tumour recurrence and stage progression in bacillus Calmette-Guérin (BCG)-relapsing non-muscle-invasive bladder cancer, defined as recurrence after achieving a disease-free status for 6 months. PATIENTS AND METHODS • A total of 183 patients with BCGrelapsing tumours were treated with conservative therapy between 1985 and 2008 at our three institutions. • We analysed the association between their clinicopathological parameters and subsequent tumour recurrence or stage progression. RESULTS • Additional induction courses of BCG or anticancer drug (mitomycin C or epirubicin) instillations were performed in 119 patients and 24 patients, respectively. The remaining 40 patients did not undergo any adjuvant therapy. • Multivariate analysis showed that a relapsing tumour with a pathologically high risk (defined as tumours with G3 and/or pT1 and/or concomitant carcinoma in situ ) was a significant risk factor for subsequent tumour recurrence ( P = 0.002; hazard ratio [ HR ] 2.15). Additional BCG instillation significantly decreased the subsequent tumour recurrence rate ( P < 0.001; HR 0.41). • Multivariate analysis also showed that a relapsing tumour with a pathologically high risk was also significantly associated with stage progression ( P < 0.001; HR 8.05). CONCLUSIONS • An additional course of BCG instillation might be effective in patients with BCG-relapsing tumours with pathologically intermediate risk. • Nevertheless, some patients with high-risk pathological features developed subsequent stage progression. Such patients should be followed up closely and counselled on the need for aggressive therapeutic options, such as radical cystectomy.
KW - Bacille Calmette-Guérin
KW - BCG failure
KW - BCG relapsing
KW - Non-muscle-invasive bladder cancer
KW - Stage progression
KW - Tumour recurrence
UR - http://www.scopus.com/inward/record.url?scp=84876421194&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84876421194&partnerID=8YFLogxK
U2 - 10.1111/j.1464-410X.2012.11194.x
DO - 10.1111/j.1464-410X.2012.11194.x
M3 - Article
VL - 110
JO - BJU International
JF - BJU International
SN - 1464-4096
IS - 11 B
ER -