Mp71-14 Long Term Outcomes of Low and Intermediate Risk Bladder Cancer Patients Treated With Transurethral Resection Eligible for Active Surveillance

You have accessJournal of UrologyBladder Cancer: Non-invasive IV (MP71)1 May 2024MP71-14 LONG TERM OUTCOMES OF LOW AND INTERMEDIATE RISK BLADDER CANCER PATIENTS TREATED WITH TRANSURETHRAL RESECTION ELIGIBLE FOR ACTIVE SURVEILLANCE Pietro Scilipoti, Avesani Giulio, Mattia Longoni, De Angelis Mario, Chiara Re, Leonardo Quarta, Alessandro Bertini, Giusy Burgio, Francesco Pellegrino, Giuseppe Rosiello, Andrea Necchi, Daniele Raggi, Roberta Lucianò, Umberto Capitanio, Giorgio Gandaglia, Renzo Colombo, Andrea Salonia, Francesco Montorsi, Alberto Briganti, and Marco Moschini Pietro ScilipotiPietro Scilipoti , Avesani GiulioAvesani Giulio , Mattia LongoniMattia Longoni , De Angelis MarioDe Angelis Mario , Chiara ReChiara Re , Leonardo QuartaLeonardo Quarta , Alessandro BertiniAlessandro Bertini , Giusy BurgioGiusy Burgio , Francesco PellegrinoFrancesco Pellegrino , Giuseppe RosielloGiuseppe Rosiello , Andrea NecchiAndrea Necchi , Daniele RaggiDaniele Raggi , Roberta LucianòRoberta Lucianò , Umberto CapitanioUmberto Capitanio , Giorgio GandagliaGiorgio Gandaglia , Renzo ColomboRenzo Colombo , Andrea SaloniaAndrea Salonia , Francesco MontorsiFrancesco Montorsi , Alberto BrigantiAlberto Briganti , and Marco MoschiniMarco Moschini View All Author Informationhttps://doi.org/10.1097/01.JU.0001009548.76580.ba.14AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Active surveillance has been recently proposed as an alternative to trans-urethral resection of bladder tumor (TURBT) for low (LR) and intermediate risk (IR) non-muscle invasive bladder cancer (NMIBC) patients. We evaluated oncological outcomes of patients deemed eligible for active surveillance (AS) according to IBCG criteria that underwent TURBT. METHODS: We retrospectively analyzed data of 280 LR and IR NMIBCs according to the international bladder cancer group (IBCG) definition treated with TURBT and subsequent Mitomycin C (MMC) or BCG intravesical instillation from 2010 to 2022 at a tertiary referral center. Active surveillance criteria were defined as follows: ≤5 lesions, no gross hematuria, negative urinary cytology, and size ≤1 cm. We divided patients according to additional IBCG risk factors: highly recurrent tumor (>1/year), multifocality (>1 lesion), prior intravesical treatment failure, early recurrence (≥1 within 1 year). Stratification was defined as follows: <2 and ≥2 risk factors. A Kaplan Meier curve analysis depicted the 48 months recurrence free survival (RFS). To assess whether increasing risk factors may increase the risk of recurrence, we performed a Multivariable Cox regression analysis (MVA) adjusted for adequate intravesical treatment. RESULTS: A total of 137 patients were selected according to inclusion criteria. Median age was 70 years (IQR 62-76). During a median follow-up of 45(IQR 28-56) months, 48 (35%) patients recurred and 4 (3%) patients experienced progression. Ta tumors were 96% (n=131) and 112(82%) patients had LG/G2 tumors. Four-year RFS rates were 90% and 60% for patients harboring <2 and ≥2 risk factors, respectively (Figure 1-p=0.001). Patients experiencing progression all had at least 2 risk factors. At a landmark time point of 48 months follow up, having ≥2 risk factors was an independent predictor of recurrence HR 3.42, 95%CI 1.15-8.32, p=0.028. CONCLUSIONS: Active Surveillance is a feasible strategy for IBCG-LR and -IR patients with negative cytology, less than 5 lesions, no gross hematuria and size ≤1 cm. Because of the higher rate of recurrence and progression, careful assessment is needed in patients with ≥2 risk IBCG factors during active surveillance protocols enrollment. Download PPT Source of Funding: - © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e1166 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Pietro Scilipoti More articles by this author Avesani Giulio More articles by this author Mattia Longoni More articles by this author De Angelis Mario More articles by this author Chiara Re More articles by this author Leonardo Quarta More articles by this author Alessandro Bertini More articles by this author Giusy Burgio More articles by this author Francesco Pellegrino More articles by this author Giuseppe Rosiello More articles by this author Andrea Necchi More articles by this author Daniele Raggi More articles by this author Roberta Lucianò More articles by this author Umberto Capitanio More articles by this author Giorgio Gandaglia More articles by this author Renzo Colombo More articles by this author Andrea Salonia More articles by this author Francesco Montorsi More articles by this author Alberto Briganti More articles by this author Marco Moschini More articles by this author Expand All Advertisement PDF downloadLoading ...