Predictors and prognostic implications of clinical decisions in patients with primary high-risk non-muscle-invasive bladder cancer - results of a cross country retrospective study

• Published in: Neoplasma 2018, Vol.65 (1), p.147-152
• Main Authors: Poletajew, S, Biernacki, R, Buraczynski, P, Chojnacki, J, Czarniecki, S, Gajewska, D, Pohaba, T, Sondka-Migdalska, J, Skrzypczyk, M, Suchojad, T, Wojtkowiak, D, Zaforemski, B, Zapala, L, Zemla, A, Radziszewski, P
• Format: Article
• Language: English
• ISSN: 0028-2685
• DOI: 10.4149/neo_2018_170217N123

Adjuvant diagnostic and therapeutic procedures are available to reduce the risk of recurrence or progression in patients with high-risk non-muscle-invasive bladder cancer (NMIBC). However, their indications and efficacy remain a matter of debate. The aim of this study was to analyze therapeutic decisions in patients with primary high-risk NMIBC and to analyze the adherence to clinical guidelines in this field.545 consecutive patients, aged a median of 70.3 years, diagnosed with primary high-risk NMIBC in thirteen urological institutions, were enrolled into this retrospective study. Diagnostic and therapeutic decisions after transurethral resection (TUR) were recorded, and predictive factors were analyzed.Restaging TUR was offered to 260 patients (47.7%), up-front intravesical Bacillus Calmette-Guerin (BCG) therapy to 74 patients (13.6%), immediate radical cystectomy to 38 patients (7.0%), and intravesical chemotherapy with the maintenance therapy to 12 patients (2.2%). No additional procedure was performed in 161 patients (29.5%). The strongest predictive factor for restaging TUR was G3 or high-grade cancer (RR 1.68, p