Recurrence and Progression in Non-Muscle-Invasive Bladder Cancer Using EORTC Risk Tables

Altieri, Vincenzo; Castellucci, Roberto; Palumbo, Pietro; Verratti, Vittore; Sut, Michał; Olivieri, R; Manco, Rossella; Ricciardulli, S.; Nicolai, Michele; P, Criniti; Tenaglia, R.

doi:10.1159/000336516

Cited by 20 publications

(21 citation statements)

References 32 publications

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“…In order to preserve homogenous patient groups we excluded patients with secondary MIBC, if no intravesical BCG therapy had been performed (n = 11) or no re-resection at the time of T1 stage and/or CIS had been performed (n = 3). In secondary MIBC, EORTC risk scores at the time of the last TURBT for NMIBC were assessed, resulting in a score from 0 to 23 [4]: (a) number of tumours (single: 0, multiple: 3); (b) tumour size (<3 cm: 0, ≥3 cm: 3); (c) prior recurrence rate (primary: 0, recurrent: 2); (d) T category (cTa: 0, cT1: 4); (e) presence of concomitant CIS (no: 0, yes: 6); (f) grade (G1-2: 0, G3: 5). Subsequently, we devised different risk groups, as reported by Sylvester et al [3].…”

Section: Methodsmentioning

confidence: 99%

“…Current guidelines recommend radical cystectomy (RC) with bilateral pelvic lymphadenectomy in MIBC and in NMIBC with high risk of progression [2,3]. Risk of progression to MIBC is usually determined by the EORTC risk score combining various clinicopathological parameters [2,3,4]. Risk of cancer-specific mortality following RC for MIBC is usually determined by pathological tumour stage and lymph node status.…”

Section: Introductionmentioning

confidence: 99%

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Oncological Outcome of Primary versus Secondary Muscle-Invasive Bladder Cancer Is Comparable after Radical Cystectomy

et al. 2013

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Background: High-risk non-muscle-invasive bladder cancer (NMIBC) progressing to muscle-invasive bladder cancer (MIBC) is associated with adverse tumour biology. It is unclear, however, whether outcome of NMIBC progressing to MIBC is adverse compared to primary MIBC and whether NMIBC of higher risk of progression to MIBC is adverse compared to NMIBC of lower risk. Objective: Our objective was to assess cancer-specific survival (CSS) following radical cystectomy (RC) for primary MIBC and for NMIBC progressing to MIBC in dependence of EORTC risk score. Materials and Methods: Clinical and histopathological characteristics and CSS of 150 patients were assessed. Secondary MIBCs were stratified by EORTC risk score at the last transurethral resection of bladder tumour for NMIBC. Results: CSS did not differ significantly between primary and secondary MIBC (p = 0.521). Secondary MIBC with high EORTC score had significantly shorter CSS compared to secondary MIBC with intermediate EORTC score (p = 0.029). In multivariable analysis, pathological tumour stage (HR = 3.77; p = 0.020) and lymph node stage (HR = 2.34; p = 0.022) were significantly correlated with CSS. Conclusion: While the outcome of secondary MIBC is not generally adverse compared to primary MIBC, the EORTC risk score not only reflects high risk of progression of NMIBC to MIBC, but also worse outcome following RC for secondary MIBC. Timely RC should thus be debated in high-risk NMIBC.

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Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Oncological Outcome of Primary versus Secondary Muscle-Invasive Bladder Cancer Is Comparable after Radical Cystectomy

et al. 2013

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“…The clinical outcome of patients with non-muscle-invasive BCa (NMIBC) and muscle-invasive BCa (MIBC) is predictable by TNM stage, WHO grade, presence of carcinoma in situ, multifocality and lymphatic invasion [1,2]. However, the clinical course of patients with similar tumor characteristics may differ considerably, and subclassification of BCa patients based on other parameters would be desirable to predict outcome more accurately and to improve treatment.…”

Section: Introductionmentioning

confidence: 99%

Alterations of Global Histone H3K9 and H3K27 Methylation Levels in Bladder Cancer

et al. 2014

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Background: Epigenetic alterations, including histone modifications, play an important role during carcinogenesis. This study was designed to systematically investigate histone H3K9 and H3K27 methylation levels in bladder cancer (BCa) tissue. Methods: A tissue microarray with urothelial BCa (150 non-muscle-invasive BCa, NMIBC; 121 muscle-invasive BCa, MIBC; 31 metastatic BCa, MET) and normal urothelium (29, CTRL) specimen was used to determine the global levels of H3K9 and H3K27 mono-, di- and tri-methylation. Results: Global levels of H3K9 and H3K27 methylation were significantly higher in CTRL than in BCa, and levels in NMIBC were higher compared to MIBC. Histone methylation levels of MET resembled MIBC. We observed furthermore a correlation of histone methylation levels with pT stage (H3K9me1, H3K9me2, H3K9me3, H3K27me1, H3K27me3) and grade (H3K9me2, H3K9me3, H3K27me1) in NMIBC. H3K9me1, H3K9me3, H3K27me1 and H3K27me3 levels were also correlated with pT stage in MIBC. Histone modifications were not associated with recurrence-free or cancer-specific survival. Conclusions: Global histone H3K9 and H3K27 methylation levels are altered in BCa.

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“…Invasion of the lamina propria, tumour grade and carcinoma in situ (CIS) represent significant risk factors for the progression of non-muscle-invasive bladder cancer [1,2]. Despite these risk factors, predicting T1 bladder cancer behaviour remains difficult [3].…”

Section: Introductionmentioning

confidence: 99%

The Prognostic Value of T1 Bladder Cancer Substaging: A Single Institution Retrospective Study

Soukup¹,

Dušková

Pešl³

et al. 2014

Urol Int

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Objective: To evaluate the prognostic value of the depth of lamina propria invasion in patients with T1 bladder cancer. Subjects and Methods: 200 patients were treated between the years 2002 and 2009. Tumours with depth of invasion above the muscularis mucosae level were categorised as pT1a and those with depth of invasion up to or beyond the muscularis mucosae as pT1b. Results: Categorisation for pT1a and pT1b was performed in 176 of 200 patients (88%). In 10 patients a muscle-invasive tumour was found in re-transurethral resection samples. 131 (79%) of 166 analysed patients had pT1a tumour and 35 (21%) had pT1b tumour. During the follow-up, in 101 (61%) patients the tumour had recurred and in 27 (16.3%) the tumour had progressed. Of all the investigated parameters, T1 substaging (p < 0.0001), grade (p = 0.0003) and the number of bacillus Calmette-Guérin instillations (p = 0.0490) were significant in predicting progression. The only significant factor for disease-specific survival was T1 substaging in univariable (p = 0.0008) and multivariable (hazard ratio 4.407) analysis. T1 substaging (p = 0.0149) and tumour multiplicity (p = 0.0448) have a statistically significant prognostic value with respect to overall survival. Conclusions: Deep invasion of the lamina propria is a significant adverse prognostic factor for tumour progression, disease-specific survival and overall survival.

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Recurrence and Progression in Non-Muscle-Invasive Bladder Cancer Using EORTC Risk Tables

Cited by 20 publications

References 32 publications

Oncological Outcome of Primary versus Secondary Muscle-Invasive Bladder Cancer Is Comparable after Radical Cystectomy

Oncological Outcome of Primary versus Secondary Muscle-Invasive Bladder Cancer Is Comparable after Radical Cystectomy

Alterations of Global Histone H3K9 and H3K27 Methylation Levels in Bladder Cancer

The Prognostic Value of T1 Bladder Cancer Substaging: A Single Institution Retrospective Study

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