Affordable Access

deepdyve-link
Publisher Website

Clinical Outcome of Patients with T1 Micropapillary Urothelial Carcinoma of the Bladder

Authors
  • Spaliviero, Massimiliano
  • Dalbagni, Guido
  • Bochner, Bernard H.
  • Poon, Bing Ying
  • Huang, Hongying
  • Al-Ahmadie, Hikmat A.
  • Donahue, Timothy F.
  • Taylor, Jennifer M.
  • Meeks, Joshua J.
  • Sjoberg, Daniel D.
  • Donat, S. Machele
  • Reuter, Victor E.
  • Herr, Harry W.1, 2, 3, 4, 5, 4, 6, 4
  • 1 Urology Service
  • 2 Department of Surgery
  • 3 Sidney Kimmel Center for Prostate and Urologic Cancers
  • 4 Memorial Sloan-Kettering Cancer Center
  • 5 Department of Epidemiology and Biostatistics
  • 6 Department of Pathology
Type
Published Article
Journal
The Journal of Urology
Publisher
Elsevier
Publication Date
Jan 01, 2014
Accepted Date
Feb 26, 2014
Identifiers
DOI: 10.1016/j.juro.2014.02.2565
Source
Elsevier
Keywords
License
Unknown

Abstract

PurposeTo report cancer-specific outcomes of micropapillary NMIBC. Materials and MethodsThe records of 36 patients restaged within three months of initial micropapillary NMIBC diagnosis were retrospectively reviewed. Early radical cystectomy ([RC] within a three-month landmark after restaging transurethral resection of bladder tumor [TURBT]), or conservative management (intravesical Bacillus Calmette-Guérin, surveillance, or deferred RC) was offered according to surgeon and patient preference. Cumulative incidence of cancer-specific mortality (CSM) and metastasis was estimated using Kaplan-Meier methods. Differences in cumulative incidence of CSM and metastasis between groups were tested using the log rank test. ResultsMedian patient age was 68 (interquartile range [IQR] 63, 77) years. Male-to-female ratio was 3:1. At restaging, all patients had ≤cT1 disease. Fifteen (42%) patients underwent early RC; 21 (58%) conservative management. Median follow-up time from landmark for cancer-specific survivors was 3.1 years (IQR 1.1, 5.9). Five-year cumulative incidence of CSM was 17% in the early RC group and 25% in the conservative management group, with an absolute difference of 7% (95% confidence interval [CI]: -26%, 41%; p = 0.8). The 5-year cumulative incidence of metastasis was 21% and 34%, respectively, with an absolute difference of 13% (95% CI: -23%, 49%; p = 0.9). The extent of the micropapillary component was not significantly associated with CSM (p = 0.4) or metastasis (p = 0.9). ConclusionsUsing proper selection criteria, including patient and pathologic factors, certain patients with cT1 micropapillary UC managed conservatively were not found to have significantly worse outcomes compared to patients undergoing early radical cystectomy.

Report this publication

Statistics

Seen <100 times