Optimal Management for Primary High Grade Ta Bladder Cancer: Role of re‐staging TURBT and Intravesical Adjuvant Therapy
Abstract Objective This study aims to investigate the impact of risk group classification, restaging transurethral resection (re‐TURBT), and adjuvant treatment intensity on recurrence and progression risks in high‐grade Ta tumours in patients with non‐muscle invasive bladder cancer (NMIBC). Material...
Saved in:
| Main Authors: | , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2024-08-01
|
| Series: | BJUI Compass |
| Subjects: | |
| Online Access: | https://doi.org/10.1002/bco2.363 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1850133122938568704 |
|---|---|
| author | Tarek Ajami Sunwoo Han Ruben Blachman‐Braun Helen Y. Hougen Yuval Avda Mark L. Gonzalgo Bruno Nahar Sanoj Punnen Dipen J. Parekh Isildinha M. Reis Chad R. Ritch |
| author_facet | Tarek Ajami Sunwoo Han Ruben Blachman‐Braun Helen Y. Hougen Yuval Avda Mark L. Gonzalgo Bruno Nahar Sanoj Punnen Dipen J. Parekh Isildinha M. Reis Chad R. Ritch |
| author_sort | Tarek Ajami |
| collection | DOAJ |
| description | Abstract Objective This study aims to investigate the impact of risk group classification, restaging transurethral resection (re‐TURBT), and adjuvant treatment intensity on recurrence and progression risks in high‐grade Ta tumours in patients with non‐muscle invasive bladder cancer (NMIBC). Materials and methods Data from a comprehensive bladder cancer database were utilized for this study. Patients with primary high‐grade Ta tumours were included. Risk groups were classified according to AUA/SUO criteria. Tumour characteristics and patient demographics were analysed using descriptive statistics. Cox proportional hazard regression models were used to assess the effect of re‐TURBT and other clinical/treatment‐related predictors on recurrence‐ and progression‐free survivals. The survivals by selected predictors were estimated using Kaplan–Meier method, and groups were compared by the log‐rank test. Results Among 218 patients with high‐grade Ta bladder cancer, those who underwent re‐TURBT had significantly better 5‐year recurrence‐free survival (71.1% vs. 26.8%, p = 0.0009) and progression‐free survival (98.6% vs. 73%, p = 0.0018) compared with those with initial TURBT alone. Full BCG treatment (induction and maintenance) showed lower recurrence risk, especially in high‐risk patients. However, residual disease at re‐TURBT did not significantly affect recurrence risk. Conclusions This study highlights the significance of risk group classification, the role of re‐TURBT, and the intensity of adjuvant treatment in the management of high‐grade Ta tumours. A risk‐adapted model is crucial to reduce the burden of unnecessary intravesical treatment and endoscopic procedures. |
| format | Article |
| id | doaj-art-a6dbe1d817e84a5484e83508d30cb1dd |
| institution | OA Journals |
| issn | 2688-4526 |
| language | English |
| publishDate | 2024-08-01 |
| publisher | Wiley |
| record_format | Article |
| series | BJUI Compass |
| spelling | doaj-art-a6dbe1d817e84a5484e83508d30cb1dd2025-08-20T02:32:04ZengWileyBJUI Compass2688-45262024-08-015891391910.1002/bco2.363Optimal Management for Primary High Grade Ta Bladder Cancer: Role of re‐staging TURBT and Intravesical Adjuvant TherapyTarek Ajami0Sunwoo Han1Ruben Blachman‐Braun2Helen Y. Hougen3Yuval Avda4Mark L. Gonzalgo5Bruno Nahar6Sanoj Punnen7Dipen J. Parekh8Isildinha M. Reis9Chad R. Ritch10Desai Sethi Urology Institute University of Miami Miller School of Medicine Miami FL United StatesBiostatistics and Bioinformatics Shared Resource Sylvester Comprehensive Cancer Center University of Miami Miller School of Medicine Miami FL United StatesDesai Sethi Urology Institute University of Miami Miller School of Medicine Miami FL United StatesDepartment of Urology University of Iowa Hospitals and Clinics Iowa City IA United StatesDesai Sethi Urology Institute University of Miami Miller School of Medicine Miami FL United StatesDesai Sethi Urology Institute University of Miami Miller School of Medicine Miami FL United StatesDesai Sethi Urology Institute University of Miami Miller School of Medicine Miami FL United StatesDesai Sethi Urology Institute University of Miami Miller School of Medicine Miami FL United StatesDesai Sethi Urology Institute University of Miami Miller School of Medicine Miami FL United StatesBiostatistics and Bioinformatics Shared Resource Sylvester Comprehensive Cancer Center University of Miami Miller School of Medicine Miami FL United StatesDesai Sethi Urology Institute University of Miami Miller School of Medicine Miami FL United StatesAbstract Objective This study aims to investigate the impact of risk group classification, restaging transurethral resection (re‐TURBT), and adjuvant treatment intensity on recurrence and progression risks in high‐grade Ta tumours in patients with non‐muscle invasive bladder cancer (NMIBC). Materials and methods Data from a comprehensive bladder cancer database were utilized for this study. Patients with primary high‐grade Ta tumours were included. Risk groups were classified according to AUA/SUO criteria. Tumour characteristics and patient demographics were analysed using descriptive statistics. Cox proportional hazard regression models were used to assess the effect of re‐TURBT and other clinical/treatment‐related predictors on recurrence‐ and progression‐free survivals. The survivals by selected predictors were estimated using Kaplan–Meier method, and groups were compared by the log‐rank test. Results Among 218 patients with high‐grade Ta bladder cancer, those who underwent re‐TURBT had significantly better 5‐year recurrence‐free survival (71.1% vs. 26.8%, p = 0.0009) and progression‐free survival (98.6% vs. 73%, p = 0.0018) compared with those with initial TURBT alone. Full BCG treatment (induction and maintenance) showed lower recurrence risk, especially in high‐risk patients. However, residual disease at re‐TURBT did not significantly affect recurrence risk. Conclusions This study highlights the significance of risk group classification, the role of re‐TURBT, and the intensity of adjuvant treatment in the management of high‐grade Ta tumours. A risk‐adapted model is crucial to reduce the burden of unnecessary intravesical treatment and endoscopic procedures.https://doi.org/10.1002/bco2.363non‐muscle invasive bladder cancerprogression‐free survivalrecurrence‐free survivalrestaging transurethral resection of bladder tumour |
| spellingShingle | Tarek Ajami Sunwoo Han Ruben Blachman‐Braun Helen Y. Hougen Yuval Avda Mark L. Gonzalgo Bruno Nahar Sanoj Punnen Dipen J. Parekh Isildinha M. Reis Chad R. Ritch Optimal Management for Primary High Grade Ta Bladder Cancer: Role of re‐staging TURBT and Intravesical Adjuvant Therapy BJUI Compass non‐muscle invasive bladder cancer progression‐free survival recurrence‐free survival restaging transurethral resection of bladder tumour |
| title | Optimal Management for Primary High Grade Ta Bladder Cancer: Role of re‐staging TURBT and Intravesical Adjuvant Therapy |
| title_full | Optimal Management for Primary High Grade Ta Bladder Cancer: Role of re‐staging TURBT and Intravesical Adjuvant Therapy |
| title_fullStr | Optimal Management for Primary High Grade Ta Bladder Cancer: Role of re‐staging TURBT and Intravesical Adjuvant Therapy |
| title_full_unstemmed | Optimal Management for Primary High Grade Ta Bladder Cancer: Role of re‐staging TURBT and Intravesical Adjuvant Therapy |
| title_short | Optimal Management for Primary High Grade Ta Bladder Cancer: Role of re‐staging TURBT and Intravesical Adjuvant Therapy |
| title_sort | optimal management for primary high grade ta bladder cancer role of re staging turbt and intravesical adjuvant therapy |
| topic | non‐muscle invasive bladder cancer progression‐free survival recurrence‐free survival restaging transurethral resection of bladder tumour |
| url | https://doi.org/10.1002/bco2.363 |
| work_keys_str_mv | AT tarekajami optimalmanagementforprimaryhighgradetabladdercancerroleofrestagingturbtandintravesicaladjuvanttherapy AT sunwoohan optimalmanagementforprimaryhighgradetabladdercancerroleofrestagingturbtandintravesicaladjuvanttherapy AT rubenblachmanbraun optimalmanagementforprimaryhighgradetabladdercancerroleofrestagingturbtandintravesicaladjuvanttherapy AT helenyhougen optimalmanagementforprimaryhighgradetabladdercancerroleofrestagingturbtandintravesicaladjuvanttherapy AT yuvalavda optimalmanagementforprimaryhighgradetabladdercancerroleofrestagingturbtandintravesicaladjuvanttherapy AT marklgonzalgo optimalmanagementforprimaryhighgradetabladdercancerroleofrestagingturbtandintravesicaladjuvanttherapy AT brunonahar optimalmanagementforprimaryhighgradetabladdercancerroleofrestagingturbtandintravesicaladjuvanttherapy AT sanojpunnen optimalmanagementforprimaryhighgradetabladdercancerroleofrestagingturbtandintravesicaladjuvanttherapy AT dipenjparekh optimalmanagementforprimaryhighgradetabladdercancerroleofrestagingturbtandintravesicaladjuvanttherapy AT isildinhamreis optimalmanagementforprimaryhighgradetabladdercancerroleofrestagingturbtandintravesicaladjuvanttherapy AT chadrritch optimalmanagementforprimaryhighgradetabladdercancerroleofrestagingturbtandintravesicaladjuvanttherapy |