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TitlePredictors of residual T1 high grade on re-transurethral resection in a large multi-institutional cohort of patients with primary T1 high-grade/grade 3 bladder cancer
Author(s)Ferro, Matteo
Di Lorenzo, Giuseppe
Buonerba, Carlo
Lucarelli, Giuseppe
Russo, Giorgio Ivan
Cantiello, Francesco
Farhan, Abdal Rahman Abu
Di Stasi, Savino
Musi, Gennaro
Hurle, Rodolfo
Vincenzo, Serretta
Busetto, Gian Maria
De Berardinis, Ettore
Perdonà, Sisto
Borghesi, Marco
Schiavina, Riccardo
Almeida, Gilberto L
Bove, Pierluigi
Lima, Estêvão Augusto Rodrigues de
Grimaldi, Giovanni
Matei, Deliu Victor
Mistretta, Francesco Alessandro
Crisan, Nicolae
Terracciano, Daniela
Paolo, Verze
Battaglia, Michele
Guazzoni, Giorgio
Autorino, Riccardo
Morgia, Giuseppe
Damiano, Rocco
Muto, Matteo
Rocca, Roberto La
Mirone, Vincenzo
de Cobelli, Ottavio
Vartolomei, Mihai Dorin
Keywordsbladder cancer
neutrophil-to-lymphocytes ratio
re-transurethral resection
Issue date2018
PublisherIvyspring International Publisher
JournalJournal of Cancer
Abstract(s)The aim of this multi-institutional study was to identify predictors of residual high-grade (HG) disease at re-transurethral resection (reTUR) in a large cohort of primary T1 HG/Grade 3 (G3) bladder cancer patients. A total of 1155 patients with primary T1 HG/G3 bladder cancer from 13 academic institutions that underwent a reTUR within 6 weeks after first TUR were evaluated. Logistic regression analysis was performed to assess the association of predictive factors with residual HG at reTUR. Residual HG cancer was found in 288 (24.9%) of patients at reTUR. Patients presenting residual HG cancer were more likely to have carcinoma in situ (CIS) at first resection (p<0.001), multiple tumors (p=0.02), and tumor size larger than 3 cm (p=0.02). Residual HG disease at reTUR was associated with increased preoperative neutrophil-to-lymphocytes ratio (NLR) (p=0.006) and body mass index (BMI)>=25 kg/m2. On multivariable analysis, independent predictors for HG residual disease at reTUR were tumor size >3cm (OR = 1.37; 95% CI: 1.02-1.84, p=0.03), concomitant CIS (OR 1.92; 95% CI: 1.32-2.78, p=0.001), being overweight (OR= 2.08; 95% CI: 1.44-3.01, p<0.001) and obesity (OR 2.48; 95% CI: 1.64-3.77, p<0.001). A reTUR in high grade T1 bladder cancer is mandatory as about 25% of patients, presents residual high grade disease. Independent predictors to identify patients at risk of residual high grade disease after a complete TUR include tumor size, presence of carcinoma in situ, and BMI >=25 kg/m2.
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Appears in Collections:ICVS - Artigos em Revistas Internacionais com Referee

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