No abstract

Recurrence patterns were defined a recurrence at 3,6,12 and >12 months (m). Patients who underwent cystectomy at any time after BCG were identified. Based on Cox proportional hazard models, we analyzed the patterns of progression, cystectomy or disease specific mortality (DSM) according to the timing of recurrence.RESULTS: A total of 316 T1G3 patients with median follow-up of 70 (2-210) months were included, of whom 26 (8.2%) presented recurrence at 3 m, 33 (10,4%) at 6 m, 27(8.5%) at 12 m and 70(22.2%) at <12m. Median time to first recurrence was 11.3 (IQR: 3-105) m, and median time to progression 11 (IQR: 18-22.5 m). Recurrence at 3 and 6 m. were associated with a higher proportion of CIS (p¼0.007). There was no difference in progression to T2 or greater between 3m (34.6%vs.31.5%.p¼0.759),6m (33.9%vs.30.9%. p¼0.70) and the rest of recurrence intervals. Cystectomy was performed in 70 of 156 patients who had recurrence. Patients who had recurrence at 6m had a significant higher cystectomy rate than those with late recurrence (77.5% vs.55.7%.p¼0.022). In the adjusted regression model only patients who presented recurrence after 3m. was independenty related to less risk to DSM (OR¼ 0.26 ;CI 95% 0.10-0.69, p¼0.007) CONCLUSIONS: The results of our study confirm that T1G3 patients who present recurrence at 3m have a worse CSS. When patients present recurrence at 6 m there is a higher frequency of cystectomy but not higher probabilty to progression.Patients that recur at three months after primary treatment with complete TUR and BCG are at higher risk of dying of the disease if more or another conservative treatment is continued.