Comprehensive assessment of oncological outcomes in 186 patients with high-risk non-muscle-invasive bladder cancer: A single institution retrospective study

Bladder Cancer
05/08/2020

Mol Clin Oncol. 2020 Sep;13(3):16. doi: 10.3892/mco.2020.2086. Epub 2020 Jul 6.

ABSTRACT

The aims of the current study were to analyze the oncological outcomes of patients with high-risk non-invasive bladder cancer (NMIBC) and to identify prognostic factors in these patients. The present study included 186 consecutive patients who underwent transurethral resection of the bladder tumor (TURBT) between January 2007 and June 2017 at Hamamatsu University School of Medicine and were subsequently diagnosed with high-risk NMIBC according to the classification of the European Urological


Association guidelines. The oncological outcomes, including recurrence-free survival (RFS), progression-free survival (PFS) and overall survival (OS) in the 186 patients were evaluated. Additionally, the effects of several clinicopathologiocal parameters on these outcomes were investigated. After the initial TURBT, the second transurethral resection and intravesical bacillus of Calmette-Guerin (BCG) therapy were performed for 47 (25.3%) and 108 (58.1%) patients, respectively. During the observation period of the current study, disease recurrence, disease progression and overall deaths occurred in 54 (29.0%), 14 (7.5%) and 19 (10.2%) patients, respectively. The 5-year RFS, PFS and OS rates in the 186 patients were 66.6, 90.2 and 87.2%, respectively. Multivariate analyses using the Cox proportional hazards regression model identified the following independent factors for the oncological outcomes: Tumor multiplicity and introduction of BCG therapy for RFS (P=0.018 and P<0.008, respectively), tumor multiplicity and recurrence status for PFS (P=0.043 and P=0.029, respectively), and age and tumor multiplicity for OS (P<0.008 and P=0.041, respectively). Although management following initial TURBT was insufficient, the oncological outcomes in the present series were comparable to those in previous studies targeting high-risk patients with NMIBC. However, attention should be paid to patients with factors independently associated with poor prognostic outcomes, particularly those with multiple tumors.