MP16-11: Long-term outcomes of pTa high grade intermediate and high risk bladder cancer patients
Friday, May 3, 2024 1:00 PM to 3:00 PM · 2 hr. (US/Central)
221B
Abstract
Information
Full Abstract and Figures
Author Block
Pietro Scilipoti, Leonardo Quarta*, Mattia Longoni, Mario De Angelis, Chiara Re, Giuseppe Basile, Giulio Avesani, Alessandro Bertini, Giusy Burgio, Francesco Pellegrino, Giuseppe Rosiello, Andrea Necchi, Daniele Raggi, Roberta Lucianò, Renzo Colombo, Giorgio Gandaglia, Umberto Capitanio, Andrea Salonia, Francesco Montorsi, Alberto Briganti, Marco Moschini, Milan, Italy
Introduction
European association of urology (EAU) prognostic risk models have been implemented to guide treatment selection in non-muscle invasive bladder cancer patients (NMIBC). We hypothesized that patients harbouring pTa high grade have different survival outcomes compared to other intermediate or high-risk patients.
Methods
We conducted a retrospective analysis including 397 IR- and HR- NMIBC patients treated with BCG immunotherapy accordingly to risk classification from 2010 to 2022 at a single tertiary referral center. Kaplan-Meier curves were used to estimate the 4-year recurrence-free survival (RFS) and progression-free survival (PFS) among groups and compared using long-rank test. Multivariable Cox and logistic regression analysis (MVA) were used to identify predictors of progression and BCG-failure, adjusting for adequate BCG treatment and presence of carcinoma in situ.
Results
Overall, we identified 199 HR and 198 IR patients. Of 201 TaHG NMIBC, 87 (43%) and 114 (57%) had IR and HR. After a median follow up of 44 (IQR 28-56)months, we observed 117 recurrences, 52 progressions and 88 BCG-failures. IR-TaHG and HR-TaHG had similar 4-year RFS compared to IR-Ta/T1LG tumors and HR-T1/HG tumors (68% HR-TaHG vs 71% IR-TaHG vs 70% IR-Ta/T1HG vs 71% HR-T1HG, all p> 0.05). Patients with IR-TaHG and HR-TaHG had lower estimated PFS compared to IR-Ta/T1LG group, but higher than HR-T1/HG tumors (87% HR-TaHG vs 86% IR-TaHG vs 95% IR-Ta/T1HG vs 77% HR-T1HG) (Figure 1, all p <0.05). At MVA, both IR-TaHG (HR 2.28, 95%CI 1.36-3.84, p=0.002) and HR-TaHG (HR 2.13, 95%CI 1.21-2.77, p=0.034 ) were predictors of progression, while having a higher risk of BCG failure [IR-TaHG: (OR 3.23, 95%CI 1.35-8.23, p=0.01) and [HR-TaHG: (OR 3.59, CI 1.45-9.37, p=0.007)] compared to IR-Ta/T1LG patients.
Conclusions
Among IR and HR NMIBC, patients with TaHG disease exhibited comparable risks of progression and BCG failure, regardless of their risk class stratification.
Source Of Funding
-
Author Block
Pietro Scilipoti, Leonardo Quarta*, Mattia Longoni, Mario De Angelis, Chiara Re, Giuseppe Basile, Giulio Avesani, Alessandro Bertini, Giusy Burgio, Francesco Pellegrino, Giuseppe Rosiello, Andrea Necchi, Daniele Raggi, Roberta Lucianò, Renzo Colombo, Giorgio Gandaglia, Umberto Capitanio, Andrea Salonia, Francesco Montorsi, Alberto Briganti, Marco Moschini, Milan, Italy
Introduction
European association of urology (EAU) prognostic risk models have been implemented to guide treatment selection in non-muscle invasive bladder cancer patients (NMIBC). We hypothesized that patients harbouring pTa high grade have different survival outcomes compared to other intermediate or high-risk patients.
Methods
We conducted a retrospective analysis including 397 IR- and HR- NMIBC patients treated with BCG immunotherapy accordingly to risk classification from 2010 to 2022 at a single tertiary referral center. Kaplan-Meier curves were used to estimate the 4-year recurrence-free survival (RFS) and progression-free survival (PFS) among groups and compared using long-rank test. Multivariable Cox and logistic regression analysis (MVA) were used to identify predictors of progression and BCG-failure, adjusting for adequate BCG treatment and presence of carcinoma in situ.
Results
Overall, we identified 199 HR and 198 IR patients. Of 201 TaHG NMIBC, 87 (43%) and 114 (57%) had IR and HR. After a median follow up of 44 (IQR 28-56)months, we observed 117 recurrences, 52 progressions and 88 BCG-failures. IR-TaHG and HR-TaHG had similar 4-year RFS compared to IR-Ta/T1LG tumors and HR-T1/HG tumors (68% HR-TaHG vs 71% IR-TaHG vs 70% IR-Ta/T1HG vs 71% HR-T1HG, all p> 0.05). Patients with IR-TaHG and HR-TaHG had lower estimated PFS compared to IR-Ta/T1LG group, but higher than HR-T1/HG tumors (87% HR-TaHG vs 86% IR-TaHG vs 95% IR-Ta/T1HG vs 77% HR-T1HG) (Figure 1, all p <0.05). At MVA, both IR-TaHG (HR 2.28, 95%CI 1.36-3.84, p=0.002) and HR-TaHG (HR 2.13, 95%CI 1.21-2.77, p=0.034 ) were predictors of progression, while having a higher risk of BCG failure [IR-TaHG: (OR 3.23, 95%CI 1.35-8.23, p=0.01) and [HR-TaHG: (OR 3.59, CI 1.45-9.37, p=0.007)] compared to IR-Ta/T1LG patients.
Conclusions
Among IR and HR NMIBC, patients with TaHG disease exhibited comparable risks of progression and BCG failure, regardless of their risk class stratification.
Source Of Funding
-