Prognostic Factors for Recurrence and Followup Policies in the Treatment of Superficial Bladder Cancer: Report from the British Medical Research Council Subgroup On Superficial Bladder Cancer (Urological Cancer Working Party)

Parmar, Mahesh; Freedman, Laurence S.; Hargreave, T. B.; Tolley, David A.

doi:10.1016/s0022-5347(17)38731-1

Cited by 234 publications

(123 citation statements)

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“…14 Our study shows that the risk of recurrence in multiple tumors is almost three times greater than that of single tumors, making tumor multifocality the main factor determining the risk of recurrence. Research by Allard et al, 9 Witjes et al, 15 Parmar et al, 16 and Mulders et al, 17 has shown the independence of tumor multifocality and highlight the vital role this variable plays in tumor recurrence.…”

Section: Discussionmentioning

confidence: 99%

Multivariate analysis of survival, recurrence, progression and development of mestastasis in T1 and T2a transitional cell bladder carcinoma

Alonso

Pita-Fernández

González-Carreró

et al. 2002

Cancer

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BACKGROUNDDetermination of prognosis factors associated with survival, recurrence, progression, and development of metastasis in T1 and T2a transitional cell carcinoma (TCC) of the bladder is discussed.METHODSA study was conducted of a group of 210 patients with primary bladder TCC at classification T1 (n = 175) and T2aN0M0 (n = 35). A total of 177 variables were studied in each patient. The monoclonal antibodies used were the following: DO7 (p53) and MIB‐1 (Ki‐67). Prognosis was obtained using Kaplan–Meier methodology and Cox proportional hazards model.RESULTSThe average follow‐up period was 6.7 years. Cancer‐related survival rates at 5 and 10 years were 82.96% and 74.78%, respectively. The independent survival variables were the following: age and expression of p53. Recurrence free survival at 5 and 10 years stood at 51.80% and 42.71%, respectively. The independent recurrence variables were T2a classification, tumor multifocality, tumor size of greater than 3 cm, carcinoma in situ in random biopsy, and expression of Ki‐67. Progression free survival rates at 5 and 10 years were 75.31% and 69.16%, respectively. The independent progression variables were age, T2a classification, and expression of p53. Metastasis free survival rates at 5 and 10 years stood at 87.23% and 84.55%, respectively. The expression of p53 was the sole variable to provide an independent prediction of metastasis.CONCLUSIONSThe expression of p53 clearly has an independent effect on the prediction of survival, progression and development of metastasis, showing a dose–response effect. Tumor multifocality and T2a classification are the variables that best predict recurrence. Cancer 2002;94:1677–84. © 2002 American Cancer Society.DOI 10.1002/cncr.10376

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Section: Discussionmentioning

confidence: 99%

Multivariate analysis of survival, recurrence, progression and development of mestastasis in T1 and T2a transitional cell bladder carcinoma

Alonso

Pita-Fernández

González-Carreró

et al. 2002

Cancer

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“…Some studies have suggested that tumor multifocality Staging and reporting of bladder cancer L Cheng et al is associated with poor outcome for patients with urothelial carcinoma. 130,134,135,142 Cohorts in these studies were limited to early stage (Ta and T1) bladder cancer. In a recent study of cystectomy specimens, which included more advanced cancers, tumor multifocality did not have prognostic significance.…”

Section: Tumor Sizementioning

confidence: 99%

Staging and reporting of urothelial carcinoma of the urinary bladder

et al. 2009

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“…17 Multivariate analysis from other studies has identified several risk factors for poor prognosis for Stage pTa-pT1 bladder cancer, including stage, grade, tumor multiplicity, tumor size, association with CIS, previous recurrence, and results of the 3-month cystoscopy. [2][3][4][5][6][7][8][9][10][11] These studies have also shown that lamina propria invasion is 1 of the most important prognostic indicators. All these studies have presented global information on patients with non-muscle invasive bladder cancer: both Ta and T1 tumors were included, and the tumor grades ranged from 1 to 3.…”

Section: Commentmentioning

confidence: 99%

“…3,4,10,20,23 Holmang et al 21 demonstrated that patients with Ն10 recurrences had a high risk of metastatic bladder cancer and a significant risk of dying of this disease, even if the initial diagnosis had been Stage TaG1. These data on recurrence have confirmed an earlier observation reported by Parmar et al 4 for the British Medical Research Council subgroup on non-muscle invasive bladder cancer. Our results have indicated that in patients with G2 tumors, progression is related to recurrence, but this is especially true if high-grade disease or CIS at first recurrence is present.…”

Section: Commentmentioning

confidence: 99%

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Recurrence at Three Months and High-grade Recurrence as Prognostic Factor of Progression in Multivariate Analysis of T1G2 Bladder Tumors

Palou

Rodríguez-Rubio

Millán

et al. 2009

Urology

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OBJECTIVESTo evaluate the risk factors for disease progression in the frequent subgroup of Stage T1G2 (World Health Organization 1973) bladder tumors using an analysis of a large cohort of patients with Stage T1G2 disease. METHODSA cohort of 616 patients with Stage T1G2 were treated with transurethral resection and random bladder biopsies. The mean follow-up was 4.2 years. Univariate and multivariate analyses were done using Cox regression analysis. The independent variables were multiplicity, association with carcinoma in situ (CIS), tumor size, tumor recurrence at 3 or 6 months, tumor grade, and association with CIS at first recurrence. The dependent variable was progression to muscleinvasive disease. RESULTSProgression to muscle-invasive disease was identified in 28 of the 616 patients (4.5%). On multivariate analysis, when considering recurrence at 3 months, this factor was the principal prognostic factor, with a relative risk of 4.0 (95% confidence interval 1.2-13.3), followed by the presence of high-grade disease or CIS at first recurrence (relative risk 2.8, 95% confidence interval 1.3-5.8) and CIS associated with the primary tumor (relative risk 1.8, 95% confidence interval 1.1-2.9). When considering recurrence at 6 months, more prognostic factors were involved for progression, including as multiple tumors, CIS associated with the primary tumor, recurrence at 6 months, and the presence of high-grade disease or CIS at the first recurrence. CONCLUSIONSIn primary urothelial T1G2 bladder cancer, recurrence at 3 months was the main prognostic factor related to progression. Additional factors were the association of CIS with the primary tumor and the presence of high-grade disease and/or CIS at first recurrence. UROLOGY 73: 1313UROLOGY 73: -1317UROLOGY 73: , 2009

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Prognostic Factors for Recurrence and Followup Policies in the Treatment of Superficial Bladder Cancer: Report from the British Medical Research Council Subgroup On Superficial Bladder Cancer (Urological Cancer Working Party)

Cited by 234 publications

References 12 publications

Multivariate analysis of survival, recurrence, progression and development of mestastasis in T1 and T2a transitional cell bladder carcinoma

Multivariate analysis of survival, recurrence, progression and development of mestastasis in T1 and T2a transitional cell bladder carcinoma

Staging and reporting of urothelial carcinoma of the urinary bladder

Recurrence at Three Months and High-grade Recurrence as Prognostic Factor of Progression in Multivariate Analysis of T1G2 Bladder Tumors

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