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. 2018 Apr;97(16):e0522.
doi: 10.1097/MD.0000000000010522.

Comparison of 10-year overall survival between patients with G1 and G2 grade Ta bladder tumors

Daniel Balan  1 , Orsolya Martha, Calin Bogdan Chibelean, Sabin Tataru, Septimiu Voidezan, Anca Sin, Victor Deliu Matei, Mihai Dorin Vartolomei, Giuseppe Lucarelli, Antonio Cioffi, Francesco Del Giudice, Ettore De Berardinis, Angela Borda, Gian Maria Busetto, Matteo Ferro, Akos Pytel, Daniel Porav-Hodade
Affiliations

Comparison of 10-year overall survival between patients with G1 and G2 grade Ta bladder tumors

Daniel Balan et al. Medicine (Baltimore). 2018 Apr.

Abstract

To compare long-term overall survival (OS) in patients with G1 and G2 grade Ta bladder cancer after transurethral resection of bladder tumors (TURBTs). Secondary aim was to investigate clinical and pathologic prognostic factors for OS of Ta patients, except G3/high grade (HG).A total of 243 patients, retrospectively selected, with Ta nonmuscle invasive bladder cancer (NMIBC) underwent TURBT between January 2006 and December 2008 (median follow-up 109 months). Inclusion criteria were: Ta at first manifestation, G1 or G2 grade with no associated carcinoma in situ (CIS). Seventy-nine patients were excluded due to concomitant CIS (1), G3/HG tumors (47), and lost to follow-up (31). Ethical approval was obtained from the Ethical Committee of the Mures County Hospital. Statistical analysis was performed using STATA 11.0.Following inclusion criteria, 164 patients with primary G1 or G2 Ta tumors, were enrolled. Recurrence was observed in 26 (15.8%) and progression in 5 (3%) patients. Ten-year survival in G1 patients was 67.8% (CI 54.3-78.1) and in G2 patients 59% (CI 49-67.3) (P = .31). Univariable and multivariable logistic regression analysis underlined that advanced age at diagnosis (hazard ratio [HR] 1.10) and no Bacillus Calmette-Guerin (BCG) treatment (HR 0.24 and 0.29) were independent predictors for death at 10 years after diagnosis.Long-term analysis confirms that patients with well differentiated (G1) and moderately well differentiated (G2) Ta tumors have similar OS. A longer OS was even reported in those who underwent BCG adjuvant therapy.

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Conflict of interest statement

The authors have no funding and conflicts of interest to disclose.

Figures

Figure 1
Figure 1
Histological grading according to World Health Organization (WHO) 1973 grading system: (A) G1: transverse section of a papilla; thickened urothelium with slender fibrovascular core; uniform elongated nuclei with preserved nuclear polarity and differentiation to the surface, no mitosis; (B) G2: moderately altered polarity, larger nuclei, variable in size, dense or irregular nuclear chromatin; visible nucleoli; some mitosis can be identified; (C) G3: deep architectural disorganization and severe nuclear atypia; coarse chromatin; massive cellular desquamation.
Figure 2
Figure 2
Kaplan–Meier survival estimates: (A) according to grade; (B) according to intravesical treatment.
See this image and copyright information in PMC

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