MP57-18 PROGNOSTIC IMPACT OF TUMOR-ASSOCIATED ROUND CELL INFILTRATES AT RADICAL CYSTECTOMY FOR BLADDER CANCER
2019-04-01

You have accessJournal of UrologyBladder Cancer: Basic Research & Pathophysiology II (MP57)1 Apr 2019MP57-18 PROGNOSTIC IMPACT OF TUMOR-ASSOCIATED ROUND CELL INFILTRATES AT RADICAL CYSTECTOMY FOR BLADDER CANCER Tina Schubert, Fahmy Hassan, Alexander Schmid, Markus Renninger, Arnulf Stenzl, Hubert Kübler, and Georgios Gakis* Tina SchubertTina Schubert More articles by this author , Fahmy HassanFahmy Hassan More articles by this author , Alexander SchmidAlexander Schmid More articles by this author , Markus RenningerMarkus Renninger More articles by this author , Arnulf StenzlArnulf Stenzl More articles by this author , Hubert KüblerHubert Kübler More articles by this author , and Georgios Gakis*Georgios Gakis* More articles by this author View All Author Informationhttps://doi.org/10.1097/01.JU.0000556618.86858.5aAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVES: To assess whether the presence of tumor-associated round cell infiltrates (TARCs) on histological slides obtained from cystectomy specimens impacts on oncological outcomes of patients with bladder cancer (BC). METHODS: A total of 329 consecutive patients staged cM0 BC underwent radical cystectomy (RC) between 2002 and 2013. The presence of TARCs (either located peritumorally (PRCs) and/or intratumorally (IRCs)) on histological slides was retrospectively assessed and correlated with outcomes. Kaplan-Meier analysis was used to estimate the impact of TARCs on recurrence-free (RFS), cancer-specific (CSS) and overall survival (OS). Multivariable Cox-regression analysis was carried out to assess risk factors of recurrence. The median follow-up for was 36 months (interquartile range: 9-54). RESULTS: Of the 329 patients, 43 (13.1%) exhibited IRCs, 146 (44.4%) PRCs and 140 (42.6%) no TARCs in the cystectomy specimens. Absence of TARCs was associated with higher age (p=0.045) and ECOG performance status (p=0.039), histologically advanced tumor stage (ï‚3pT3a; p<0.001), lymph node tumor involvement (pN+; p=0.021), positive surgical margins (p=0.007), lymphovascular invasion (p<0.001) and elevated serum CRP levels (p<0.001) whereas a lower rate of tumor multifocality was observed in patients with absence of TARCs (p=0.044). The 3-year RFS/CSS/OS was 74.6%/88.9%/77.3% for patients with IRCs, 68.2%/84.6%/70.7% for PRCs and 47.6%/68.2%/54.7% for patients without TARCs (p=0.001/<0.001/<0.001 for TARCs vs. no TARCs). In multivariable analysis, adjusted for all significant parameters of univariable analysis, histologically advanced tumor stage (p=0.020), node-positive disease (p=0.009) and the absence of TARCs (p=0.033) were independent prognosticators for recurrence. CONCLUSIONS: The presence of TARCs in cystectomy specimens is a strong prognosticator for improved RFS after RC. This finding suggests that the local activity of the immune system is important for effective bladder cancer control in invasive disease. Source of Funding: None Wuerzburg, Germany; Würzburg, Germany; Tuebingen, Germany; Würzburg, Germany© 2019 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 201Issue Supplement 4April 2019Page: e819-e820 Advertisement Copyright & Permissions© 2019 by American Urological Association Education and Research, Inc.MetricsAuthor Information Tina Schubert More articles by this author Fahmy Hassan More articles by this author Alexander Schmid More articles by this author Markus Renninger More articles by this author Arnulf Stenzl More articles by this author Hubert Kübler More articles by this author Georgios Gakis* More articles by this author Expand All Advertisement PDF downloadLoading ...