Primary Superficial High-Grade Bladder Cancer: Risk, Recurrence and Progression

• Autor(a) principal: Pereira, Diogo
• Data de Publicação: 2017
• Outros Autores: Botelho, Francisco, Silva, Carlos, Silva, João
• Tipo de documento: Artigo
• Idioma: eng
• Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
• Texto Completo: https://doi.org/10.24915/aup.34.1-2.30
• topic: Carcinoma In Situ; BCG Vaccine; Disease Progression; Prognosis; Neoplasm Recurrence, Local; Risk Factors; Urinary Bladder Neoplasms; Carcinoma in Situ; Factores de Risco; Neoplasias da Bexiga Urinária; Prognóstico; Progressão da Doença; Recidiva Local de Neoplasia; Vacina BCG

Purpose: We aimed to characterize the population with primary high-grade non muscle invasive bladder cancer followed in a Portuguese Central Hospital and simultaneously identify recurrence and progression rates and associated risk factors. Material and Methods: The analysis included 79 patients who were diagnosed with primary high-grade non muscle invasive bladder cancer on first transurethral resection between 2006 and 2010. Several variables were statistically analyzed to evaluate their prognostic importance. Results: With a median follow-up of 54 months, 19 patients (24.1%) recurred, four (5.1%) progressed to muscle-invasive disease and two (2.5%) underwent radical cystectomy. The most important prognostic factor of recurrence was the duration of intravesical bacillus Calmette-Guérin (BCG) treatment while the presence of carcinoma in situ was the most important prognostic factor of progression. Residual disease on second-look transurethral resection showed to reduce the recurrence-free-survival. Conclusion: In our population, recurrence and progression rates were much lower than those described in other studies. Residual disease on second-look transurethral resection is associated with decreased recurrence-free-survival while the presence of carcinoma in situ is related with higher risk of progression. The duration of treatment with BCG seems to reduce the risk of recurrence.