MP56-02 PROGNOSTIC FACTORS FOR HIGH-GRADE T1 BLADDER CANCER: A META-ANALYSIS BASED ON 7,486 PATIENTS (2014)

You have accessJournal of UrologyBladder Cancer: Superficial1 Apr 2014MP56-02 PROGNOSTIC FACTORS FOR HIGH-GRADE T1 BLADDER CANCER: A META-ANALYSIS BASED ON 7,486 PATIENTS William Martin-Doyle, Jeffrey J. Leow, Anna Orsola, Steven L. Chang, and Joaquim Bellmunt William Martin-DoyleWilliam Martin-Doyle More articles by this author , Jeffrey J. LeowJeffrey J. Leow More articles by this author , Anna OrsolaAnna Orsola More articles by this author , Steven L. ChangSteven L. Chang More articles by this author , and Joaquim BellmuntJoaquim Bellmunt More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2014.02.1570AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail Introduction and Objectives Scattered reports have described a range of outcomes in high-grade T1 (HGT1) bladder cancer. We report a large meta-analysis examining prognostic factors for recurrence, progression, and cancer-specific survival (CSS) in HGT1 disease. Methods A systematic review was conducted searching PubMed, Embase, the Cochrane library, and ASCO abstracts for studies published before September 2013. Studies meeting the following criteria were included in random-effects models for each prognostic factor/outcome: ≥75 patients (pts), ≥75% of pts having HGT1, with hazard ratios for ≥1 prognostic factor of interest (age, gender, recurrent disease, tumor number, tumor size, associated CIS, T1b/c substage, histologic pattern, and BCG). Results 41 studies were included (25 pure HGT1 studies), with a total N of 7,486 (98% with HGT1, N=5,582 in pure HGT1 studies). With a median follow-up of 53 months, 46% of pts recurred, 21% progressed, and 14% died of disease (Table). Significant risk factors for progression were depth of invasion (T1b/c: HR 3.27, p<0.001), associated CIS (HR 2.10, p<0.001), non-papillary pattern (HR 1.91, p=0.001), non-use of BCG (TUR only: HR 1.78, p<0.001), multiple tumors (HR 1.52, p=0.006), female gender (HR 1.52, p=0.014), and tumor size >3cm (HR 1.48, p=0.002). For CSS, significant (p<0.05) risk factors were non-papillary pattern, elderly age, depth of invasion, no BCG, tumor size, and associated CIS, with HRs from 1.38-2.33. For recurrence, significant risk factors were no BCG, non-papillary pattern, multiple tumors, tumor size, and associated CIS. Conclusions This meta-analysis represents the largest analysis ever conducted on prognostic factors in HGT1 disease. The worst outcomes for progression and survival were associated with depth of invasion, CIS, non-papillary histology, no BCG, and tumor size. We confirm the recent finding that females have a deleterious prognosis, as well as BCG’s positive impact on cancer-specific survival, strengthening the recommendation for its use in high-risk tumors. These factors should be used for prognostication and future patient stratification in clinical trials, with outcomes reported by gender. © 2014FiguresReferencesRelatedDetails Volume 191Issue 4SApril 2014Page: e564 Advertisement Copyright & Permissions© 2014MetricsAuthor Information William Martin-Doyle More articles by this author Jeffrey J. Leow More articles by this author Anna Orsola More articles by this author Steven L. Chang More articles by this author Joaquim Bellmunt More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...