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Abstract

To evaluate the relative importance of clinicopathological factors affecting recurrence, progression, and survival in patients with superficial bladder cancer (pTa and pT1) undergoing bacillus Calmette-Guerin (BCG) therapy (Tokyo 172 strain), we reviewed data for 146 patients treated between 1985 and 1998. The median follow-up period was 64.7 months. Tumour recurrence, progression, and death were evaluated as endpoints using Cox's proportional hazards model. The 5-year recurrence-free rate was 56% for all 146 patients. Those with a past history of bladder cancer (n = 73) had significantly earlier recurrence than those without (n = 73, p = 0.017) and this tended to be the case for concomitant CIS (n = 34) although this did not reach statistical significance. The 5-year progression rate was 15% for all 146 patients and univariate analysis revealed that the presence of concomitant CIS was significantly associated with disease progression (p = 0.002). Multivariate analysis using the proportional hazards model confirmed the finding that only one factor, concomitant CIS, was significantly associated with progression. The 5-year survival rate was 84% for all 146 patients. Furthermore, univariate and multivariate analyses revealed that patient age, history of bladder cancer, and concomitant CIS were variables significantly related to patient survival. The present findings suggest that careful follow-up is mandatory after BCG instillation therapy for patients with superficial bladder cancer and concomitant CIS because of their relatively poor prognosis.

Prognostic Factors Including Ki-67 and p53 in Bacillus Calmette-Guérin-Treated Non-Muscle-Invasive Bladder Cancer: A Prospective Study

“…Age has been recognized as the most important risk factor for development of bladder cancer, which is essentially a disease of the elderly; in our study, age showed to be associated with OS (HR 1.05, p = 0.002), but with none of the other endpoints. High tumour grade and T1 stage were found to be independent predictors of progression on multivariate analysis in a recent, large study by Fernandez-Gomez et al [16], but previous studies had failed to show such an association [17,18]. In our study, T stage was significantly associated with CSS, while it approached but did not reach statistical significance for progression (HR 3.51, p = 0.07).…”

“…In the last years, a few clinical, pathological and molecular variables have been analysed in order to assess their role in predicting response to BCG [16,17,18,19,20,21,22,23,24,25,26,27,28,29,30,31,32,33]. Reliable markers could help to identify patients at higher risk of BCG failure, worthy of undergoing early cystectomy.…”

“…In our study, T stage was significantly associated with CSS, while it approached but did not reach statistical significance for progression (HR 3.51, p = 0.07). Several reports showed that associated CIS leads to a worse outcome after BCG: Takashi et al [17] found that concomitant CIS was significantly associated with disease progression on uni- and multivariate analyses, but a subsequent retrospective analysis by Andius et al [18] conducted on 173 CIS patients demonstrated that no pretreatment variables, including type of CIS and T1G3 tumour, had prognostic value in terms of time to progression. Recently, Fernandez-Gomez et al [16] identified associated CIS as an independent factor for recurrence but not for progression.…”

Chemical degradation of polyurethanes: Degradation of flexible polyester polyurethane foam by phosphonic acid dialkyl esters

“…Recycling of polymer waste materials and used polymers is one of the ways to conserve natural resources and to reduce environmental stress. The chemical degradation of polyurethanes—rigid, flexible, or polyurethane elastomers, involves well‐known methods of hydrolysis,1 glycolysis2–4 and aminolysis 5, 6…”

Previous Bladder Cancer History in Patients with High-Risk, Non–muscle-invasive Bladder Cancer Correlates with Recurrence and Progression: Implications of Natural History

“…This multivariate analysis of four randomized CUETO trials included data from 1,062 patients with primary and relapsing high- and intermediate-risk tumors, showing a notable correlation between prior bladder cancer resections and recurrence [ 7 ]. Furthermore, Takashi et al [ 10 ] evaluated the prognostic significance of various clinicopathological factors that affect recurrence and progression in 146 patients with superficial bladder cancer undergoing BCG therapy and reported that patients with a past history of bladder cancer experienced significantly earlier recurrence than those without such history [ 10 ]. In the same way, Losa et al [ 11 ] found a connection between previous resections and recurrence in patients with non–muscle-invasive bladder tumor treated with adjuvant BCG immunotherapy.…”