2004
DOI: 10.1023/b:urol.0000032688.37789.7c
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T1G3 bladder cancer – Indications for early cystectomy

Abstract: In patients with multiple T1G3 tumours with or without associated CIS, or in those with single T1G3 tumour with associated CIS the incidence of the disease being already muscle invasive at the time of clinical diagnosis is 55%. Early radical cystectomy should be advocated in this group. Conversely, for a single T1G3 tumour without associated CIS, conservative bladder preserving strategy with immuno-chemotherapy and close surveillance is justified.

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Cited by 58 publications
(29 citation statements)
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“…Clinically, the problem associated with these tumors is their highly unpredictable potential for recurrence and progression into muscle invasive disease (11). High-grade UCB tumors with lamina propria invasion (pT 1 grade 3) represent those at the greatest risk, rendering the surgical management of this disease subject to much controversy (12). Nearly one-third of these patients will require cystectomy as a second-line treatment after failure of Bacillus Calmette-Guérin (BCG) treatment (13).…”
mentioning
confidence: 99%
“…Clinically, the problem associated with these tumors is their highly unpredictable potential for recurrence and progression into muscle invasive disease (11). High-grade UCB tumors with lamina propria invasion (pT 1 grade 3) represent those at the greatest risk, rendering the surgical management of this disease subject to much controversy (12). Nearly one-third of these patients will require cystectomy as a second-line treatment after failure of Bacillus Calmette-Guérin (BCG) treatment (13).…”
mentioning
confidence: 99%
“…Several cytogenetic [17,20] molecular genetic [21] and immunohistologic [22][23][24][25] studies have shown similar molecular alterations for CIS and muscle-invasive UCB. Several small studies have shown that the presence of concomitant CIS in patients with papillary, non-muscle-invasive UCB is associated with significantly worse clinical outcome after RC [26][27][28]. In patients with clinical stage T1 grade 3 UCB treated with RC, concomitant CIS was the only pre-cystectomy factor associated with disease recurrence and mortality in 171 patients treated with RC [7].…”
Section: Discussionmentioning
confidence: 99%
“…The risk of disease recurrence increased 2.5-fold and the risk of bladder cancerspecific death increased 3-fold when concomitant CIS was identified preoperatively. Similarly, Masood et al [26] reported that T1 grade 3 UCB patients with concomitant CIS have a higher probability of disease progression than those without concomitant CIS (55 vs. 6%). Moreover, two studies have also shown that CIS is an independent predictor of disease progression to muscle-invasive UCB [29,30].…”
Section: Discussionmentioning
confidence: 99%
“…The presence of CIS led to pathological upstaging in 55% of RC specimens, compared to only 6% of T1 tumour with no CIS [25]. Furthermore, Solsona et al [19] reported on 191 patients with invasive T1 disease (with and without CIS) and found that patients with associated CIS who had RC were at risk of progression.…”
Section: Presence Of Cismentioning
confidence: 99%
“…This prognostic relationship was examined by Masood et al [25] in patients with high-grade invasive T1 tumours. The presence of CIS led to pathological upstaging in 55% of RC specimens, compared to only 6% of T1 tumour with no CIS [25].…”
Section: Presence Of Cismentioning
confidence: 99%