High risk bladder cancer: current management and survival

Anna Leliveld-Kors, Esther Bastiaannet, Benjamin H J Doornweerd, Michael Schaapveld, Igle J de Jong

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Abstract

Purpose: To evaluate the pattern of care in patients with high risk non muscle invasive bladder cancer (NMIBC) in the Comprehensive Cancer Center North-Netherlands (CCCN) and to assess factors associated with the choice of treatment, recurrence and progression free survival rates.

Materials and Methods: Retrospective analysis of 412 patients with newly diagnosed high risk NMIBC. Clinical, demographic and follow-up data were obtained from the CCCN Cancer Registry and a detailed medical record review. Uni and multivariate analysis was performed to identify factors related to choice of treatment and 5 year recurrence and progression free survival.

Results: 74/412 (18%) patients with high risk NMIBC underwent a transurethral resection (TUR) as single treatment. Adjuvant treatment after TUR was performed in 90.7% of the patients treated in teaching hospitals versus 71.8 % in non-teaching hospitals (p <0.001). In multivariate analysis, age (60-79 years OR 0.40 and > 80 years OR 0.1 p = 0.001) and treatment in non-teaching hospitals (OR 0.25; p <0.001) were associated with less adjuvant treatment after TUR. Tumor recurrence occurred in 191/392 (49%) and progression in 84/392 (21.4%) patients. The mean 5-years progression free survival was 71.6% (95% CI 65.5-76.8).

Conclusion: In this pattern of care study in high risk NMIBC, 18% of the patients were treated with TUR as single treatment. Age and treatment in non-teaching hospitals were associated with less adjuvant treatment after TUR. None of the variables sex, age, comorbidity, hospital type, stage and year of treatment was associated with 5 year recurrence or progression rates.

Original languageEnglish
Pages (from-to)203-212
Number of pages8
JournalInternational braz j urol
Volume37
Issue number2
DOIs
Publication statusPublished - 12-May-2011

Keywords

  • urinary bladder neoplasms
  • treatment
  • outcomes
  • BACILLUS-CALMETTE-GUERIN
  • TRANSITIONAL-CELL CARCINOMA
  • RANDOMIZED CLINICAL-TRIALS
  • MITOMYCIN-C
  • HIGH-GRADE
  • INTRAVESICAL THERAPY
  • RADICAL CYSTECTOMY
  • TUMOR PROGRESSION
  • RELATIVE SURVIVAL
  • STAGE-TA

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