Impact of re-transurethral resection of bladder staging on risk stratification of high-grade T1 non-muscle-invasive bladder cancer across European Association of Urology 2021 risk groups - PubMed
8 hours ago
- #Re-TURB
- #Risk Stratification
- #Bladder Cancer
- Study evaluates the prognostic impact of T-stage at re-transurethral resection of bladder (re-TURB) on risk stratification in T1 high-grade non-muscle-invasive bladder cancer (NMIBC) patients treated with Bacillus Calmette-Guérin (BCG).
- Retrospective multicentre study involving 1403 patients from 28 European academic centres (2007-2020) stratified by re-TURB pathological stage and EAU21 risk groups.
- 38.8% of patients had residual disease at re-TURB, with 17.7% showing persistent T1 disease, which was associated with worse outcomes including high-grade recurrence and progression.
- Persistent T1 at re-TURB significantly reduced 5-year high-grade recurrence-free survival (HG-RFS), progression-free survival (PFS), and increased cancer-specific mortality (CSM) to 23%.
- Multivariable analysis confirmed residual T1 as an independent predictor of worse HG-RFS, PFS, and CSM, with lower statistical cure fractions compared to T0/Ta.
- High- and very high-risk patients with persistent T1 represent a biologically adverse subgroup where standard BCG treatment may be insufficient.