Prognosis of Primary Papillary Ta Grade 3 Bladder Cancer in the Non-muscle-invasive Spectrum
Beijert, Irene J. (Amsterdam University Medical Center (UMC))
Hentschel, Anouk E. (Amsterdam University Medical Center (UMC))
Bründl, Johannes (University of Regensburg)
Compérat, Eva M. (Sorbonne University)
Plass, Karin (European Association of Urology Guidelines Office)
Rodríguez, Oscar (Institut d'Investigació Biomèdica Sant Pau)
Subiela Henríquez, Jose D. (Hospital de la Santa Creu i Sant Pau (Barcelona, Catalunya))
Hernández, Virginia (Hospital Universitario Fundación Alcorcón)
de la Peña, Enrique (Hospital Universitario Fundación Alcorcón)
Alemany, Isabel (Hospital Universitario Fundación Alcorcón)
Turturica, Diana (University of Torino School of Medicine)
Pisano, Francesca (Hospital de la Santa Creu i Sant Pau (Barcelona, Catalunya))
Soria, Francesco (University of Torino School of Medicine)
Čapoun, Otakar (Charles University Praha)
Bauerová, Lenka (Charles University Praha)
Pešl, Michael (Charles University Praha)
Bruins, H. Maxim (Radboud University Medical Center)
Runneboom, Willemien (Radboud University Medical Center)
Herdegen, Sonja (University of Regensburg)
Breyer, Johannes (University of Regensburg)
Brisuda, Antonin (Charles University Praha)
Calatrava, Ana (Fundació Institut Valencià d'Oncologia)
Rubio-Briones, José (Fundació Institut Valencià d'Oncologia)
Seles, Maximilian (Medical University of Graz)
Mannweiler, Sebastian (Medical University of Graz)
Bosschieter, Judith (Amsterdam University Medical Center (UMC))
Kusuma, Venkata R.M. (Royal Surrey Hospital)
Ashabere, David (Royal Surrey Hospital)
Huebner, Nicolai (Vienna General Hospital)
Cotte, Juliette (Sorbonne University)
Mertens, Laura S (Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital)
Claps, Francesco (Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital)
Masson-Lecomte, Alexandra (European Association of Urology Non-muscle-invasive Bladder Cancer Guidelines Panel)
Liedberg, Fredrik (European Association of Urology Non-muscle-invasive Bladder Cancer Guidelines Panel)
Cohen, Daniel (Royal Free London NHS Foundation Trust)
Lunelli, Luca (Sorbonne University)
Cussenot, Olivier (Sorbonne University)
El Sheikh, Soha (Royal Free London NHS Foundation Trust)
Volanis, Dimitrios (Royal Free London NHS Foundation Trust)
Côté, Jean-François (Sorbonne University)
Rouprêt, Morgan (Sorbonne University)
Haitel, Andrea (Medical University Vienna)
Shariat, Shahrokh (Charles University Praha)
Mostafid, A. Hugh (Royal Surrey Hospital)
Nieuwenhuijzen, Jakko A. (Amsterdam University Medical Center (UMC))
Zigeuner, Richard (Medical University of Graz)
Dominguez-Escrig, Jose L. (Fundació Institut Valencià d'Oncologia)
Hacek, Jaromir (Charles University Praha)
Zlotta, Alexandre R. (University of Toronto)
Burger, Maximilian (University of Regensburg)
Evert, Matthias (University of Regensburg)
Hulsbergen-van de Kaa, Christina A. (Radboud University Medical Center)
van der Heijden, Antoine G. (Radboud University Medical Center)
Kiemeney, Lambertus A.L.M. (Radboud University Medical Center)
Soukup, Viktor (Charles University Praha)
Molinaro, Luca (University of Torino School of Medicine)
Gontero, Paolo (University of Torino School of Medicine)
Llorente, Carlos (Hospital Universitario Fundación Alcorcón)
Algaba, Ferran (Institut d'Investigació Biomèdica Sant Pau)
Palou, Juan (Institut d'Investigació Biomèdica Sant Pau)
N'Dow, James (European Association of Urology Guidelines Office)
Ribal, Maria J. (European Association of Urology Guidelines Office)
van der Kwast, Theodorus (University of Toronto)
Babjuk, Marek (Vienna General Hospital)
Sylvester, Richard J. (European Association of Urology Non-muscle-invasive Bladder Cancer Guidelines Panel)
van Rhijn, Bas Wilhelmus Gerardus (University of Toronto)
Universitat Autònoma de Barcelona

Data:	2023
Resum:	Ta grade 3 (G3) non-muscle-invasive bladder cancer (NMIBC) is a relatively rare diagnosis with an ambiguous character owing to the presence of an aggressive G3 component together with the lower malignant potential of the Ta component. The European Association of Urology (EAU) NMIBC guidelines recently changed the risk stratification for Ta G3 from high risk to intermediate, high, or very high risk. However, prognostic studies on Ta G3 carcinomas are limited and inconclusive. To evaluate the prognostic value of categorizing Ta G3 compared to Ta G2 and T1 G3 carcinomas. Individual patient data for 5170 primary Ta-T1 bladder tumors from 17 hospitals were analyzed. Transurethral resection of the tumor was performed between 1990 and 2018. Time to recurrence and time to progression were analyzed using cumulative incidence functions, log-rank tests, and multivariable Cox-regression models with interaction terms stratified by institution. Ta G3 represented 7. 5% (387/5170) of Ta-T1 carcinomas of which 42% were classified as intermediate risk. Time to recurrence did not differ between Ta G3 and Ta G2 (p = 0. 9) or T1 G3 (p = 0. 4). Progression at 5 yr occurred for 3. 6% (95% confidence interval [CI] 2. 7-4. 8%) of Ta G2, 13% (95% CI 9. 3-17%) of Ta G3, and 20% (95% CI 17-23%) of T1 G3 carcinomas. Time to progression for Ta G3 was shorter than for Ta G2 (p < 0. 001) and longer than for T1 G3 (p = 0. 002). Patients with Ta G3 NMIBC with concomitant carcinoma in situ (CIS) had worse prognosis and a similar time to progression as for patients with T1 G3 NMIBC with CIS (p = 0. 5). Multivariable analyses for recurrence and progression showed similar results. The prognosis of Ta G3 tumors in terms of progression appears to be in between that of Ta G2 and T1 G3. However, patients with Ta G3 NMIBC with concomitant CIS have worse prognosis that is comparable to that of T1 G3 with CIS. Our results support the recent EAU NMIBC guideline changes for more refined risk stratification of Ta G3 tumors because many of these patients have better prognosis than previously thought. We used data from 17 centers in Europe and Canada to assess the prognosis for patients with stage Ta grade 3 (G3) non-muscle-invasive bladder cancer (NMIBC). Time to cancer progression for Ta G3 cancer differed from both Ta G2 and T1 G3 tumors. Our results support the recent change in the European Association of Urology guidelines for more refined risk stratification of Ta G3 NMIBC because many patients with this tumor have better prognosis than previously thought.
Drets:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Llengua:	Anglès
Document:	Article ; recerca ; Versió publicada
Matèria:	Bladder ; Cancer ; Carcinomas ; G3 ; Grade ; Non-muscle-invasive ; Stage Ta ; Urothelial ; World Health Organization
Publicat a:	European urology oncology, Vol. 6 Núm. 2 (january 2023) , p. 214-221, ISSN 2588-9311

DOI: 10.1016/j.euo.2023.01.004
PMID: 36670042

8 p, 694.9 KB

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