Impact of patient age on outcome following bladder-preserving treatment for non-muscle-invasive bladder cancer

Kohjimoto, Yasuo; Iba, Akinori; Shintani, Yasuyo; Inagaki, Takeshi; Uekado, Yasunari; Hara, Isao

doi:10.1007/s00345-010-0514-x

Cited by 20 publications

(5 citation statements)

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“…We first observed that treatment outcome was influenced by age, treatment scheme and tumour multifocallity, as showed in other reports (Bohle and Bock, 2004; Joudi et al , 2006; Fernandez-Gomez et al , 2008; Malmstrom et al , 2009; Kohjimoto et al , 2010; Ajili et al , 2012). To overcome the samples heterogeneity, these variables were taken into account in multivariate analysis models to assess the influence of tumour-associated glycans in BCG response.…”

Section: Discussionsupporting

confidence: 60%

Response of high-risk of recurrence/progression bladder tumours expressing sialyl-Tn and sialyl-6-T to BCG immunotherapy

et al. 2013

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Background:High risk of recurrence/progression bladder tumours is treated with Bacillus Calmette-Guérin (BCG) immunotherapy after complete resection of the tumour. Approximately 75% of these tumours express the uncommon carbohydrate antigen sialyl-Tn (Tn), a surrogate biomarker of tumour aggressiveness. Such changes in the glycosylation of cell-surface proteins influence tumour microenvironment and immune responses that may modulate treatment outcome and the course of disease. The aim of this work is to determine the efficiency of BCG immunotherapy against tumours expressing sTn and sTn-related antigen sialyl-6-T (s6T).Methods:In a retrospective design, 94 tumours from patients treated with BCG were screened for sTn and s6T expression. In vitro studies were conducted to determine the interaction of BCG with high-grade bladder cancer cell line overexpressing sTn.Results:From the 94 cases evaluated, 36 had recurrence after BCG treatment (38.3%). Treatment outcome was influenced by age over 65 years (HR=2.668; (1.344–5.254); P=0.005), maintenance schedule (HR=0.480; (0.246–0.936); P=0.031) and multifocallity (HR=2.065; (1.033–4.126); P=0.040). sTn or s6T expression was associated with BCG response (P=0.024; P<0.0001) and with increased recurrence-free survival (P=0.001). Multivariate analyses showed that sTn and/or s6T were independent predictive markers of recurrence after BCG immunotherapy (HR=0.296; (0.148–0.594); P=0.001). In vitro studies demonstrated higher adhesion and internalisation of the bacillus to cells expressing sTn, promoting cell death.Conclusion:s6T is described for the first time in bladder tumours. Our data strongly suggest that BCG immunotherapy is efficient against sTn- and s6T-positive tumours. Furthermore, sTn and s6T expression are independent predictive markers of BCG treatment response and may be useful in the identification of patients who could benefit more from this immunotherapy.

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Section: Discussionsupporting

confidence: 60%

Response of high-risk of recurrence/progression bladder tumours expressing sialyl-Tn and sialyl-6-T to BCG immunotherapy

et al. 2013

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“…We previously reported that the bladder cancer recurrence risk was 2.3-fold higher for patients aged 80 years or older than those aged 60-69 years using a different cohort. 14 Joudi et al also reported that aging appeared to be associated with a decreased response to intravesical immunotherapy. 15 In fact, the factor of age is incorporated in the CUETO system, but not in the EORTC system.…”

Section: Discussionmentioning

confidence: 98%

External validation of European Organization for Research and Treatment of Cancer and Spanish Urological Club for Oncological Treatment scoring models to predict recurrence and progression in Japanese patients with non‐muscle invasive bladder cancer treated with bacillus Calmette–Guérin

et al. 2014

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Abbreviations & AcronymsObjective: To validate two prediction models (European Organization for Research and Treatment of Cancer and Spanish Urological Club for Oncological Treatment) for recurrence and progression of non-muscle invasive bladder cancer in Japanese patients who underwent bacillus Calmette-Guérin instillation therapy. Methods: From March 1985 to April 2007, data were analyzed from 366 patients who underwent transurethral resection of bladder tumor followed by bacillus Calmette-Guérin instillation therapy. The ability of two scoring models to predict recurrence and progression was assessed by concordance index. Results: For recurrence probability, the concordance index of the European Organization for Research and Treatment of Cancer and Spanish Urological Club for Oncological Treatment models was 0.514 and 0.576, respectively, which was lower than that (0.604) of a selected single prognostic factor (age) by our multivariate analysis. For progression probability, the concordance index of European Organization for Research and Treatment of Cancer and Spanish Urological Club for Oncological Treatment models was 0.693 and 0.764, respectively, which was higher than that (0.633) of a selected single factor (T stage) by our multivariate analysis. The Spanish Urological Club for Oncological Treatment scoring system resulted in better stratification of tumor recurrence and progression when compared with the European Organization for Research and Treatment of Cancer model, probably because more patients underwent bacillus Calmette-Guérin treatment in the Spanish Urological Club for Oncological Treatment cohort than in the European Organization for Research and Treatment of Cancer cohort. Conclusions: The Spanish Urological Club for Oncological Treatment scoring system is a good predictor of tumor recurrence and progression in Japanese patients who underwent bacillus Calmette-Guérin immunotherapy. A large prospective study is warranted to confirm the efficacy of this system.

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“…Similarly, Joudi et al reported, in a cohort of 412 patients with superficial BC treated with TURB plus BCG therapy, a 22% of difference in cancer free survival (CFS) among patients <70 years and >80 years (61% versus 39%, p=0.0002), with the latter that also reported a persistently lower response rate to BCG therapy [20]. Analougously, Kohjimoto et al, reported on 491 patients with non-muscle invasive BC treated with TURB followed by BCG therapy, an higher incidence of multiple and higher grades tumours in >70 patients and a lowest RFS (47.2%) and PFS (89.4%) at 2 year among >80 years patients, with a recurrence and progression risk of 2.3 and 2.8 times respectively higher compared to <70 years patients [21]. More recently, an European Organization for Reasearch and Treatment of Cancer (EORTC) trial, demonstrated, in 822 Ta-T1 patients treated with BCG or epirubicin and followed for a median of 9.2 years, a shorter time to progression, overall and cancer specific survival in patients >70 years, confirming the worse oncological outcomes in elderly patients [15].…”

Section: Discussionmentioning

confidence: 99%

Impact of Age on Outcomes of Patients With Pure Carcinoma In Situ of the Bladder: Multi-Institutional Cohort Analysis

Ferro

Chiujdea

Musi

et al. 2022

Clinical Genitourinary Cancer

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Impact of patient age on outcome following bladder-preserving treatment for non-muscle-invasive bladder cancer

Abstract: Older age adversely affected the outcome of patients with NMIBC, which is particularly apparent in patients 80 years or older. Further prospective studies to confirm these findings are warranted.

Cited by 20 publications

References 15 publications

Response of high-risk of recurrence/progression bladder tumours expressing sialyl-Tn and sialyl-6-T to BCG immunotherapy

Response of high-risk of recurrence/progression bladder tumours expressing sialyl-Tn and sialyl-6-T to BCG immunotherapy

External validation of European Organization for Research and Treatment of Cancer and Spanish Urological Club for Oncological Treatment scoring models to predict recurrence and progression in Japanese patients with non‐muscle invasive bladder cancer treated with bacillus Calmette–Guérin

Impact of Age on Outcomes of Patients With Pure Carcinoma In Situ of the Bladder: Multi-Institutional Cohort Analysis

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