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. 2024 Apr 17;5(8):799-805.
doi: 10.1002/bco2.363. eCollection 2024 Aug.

Optimal Management for Primary High Grade Ta Bladder Cancer: Role of re-staging TURBT and Intravesical Adjuvant Therapy

Tarek Ajami  1 , Sunwoo Han  2 , Ruben Blachman-Braun  1 , Helen Y Hougen  3 , Yuval Avda  1 , Mark L Gonzalgo  1 , Bruno Nahar  1 , Sanoj Punnen  1 , Dipen J Parekh  1 , Isildinha M Reis  2   4 , Chad R Ritch  1
Affiliations

Optimal Management for Primary High Grade Ta Bladder Cancer: Role of re-staging TURBT and Intravesical Adjuvant Therapy

Tarek Ajami et al. BJUI Compass. .

Erratum in

  • Erratum.
    [No authors listed] [No authors listed] BJUI Compass. 2024 Dec 30;5(12):1324-1329. doi: 10.1002/bco2.482. eCollection 2024 Dec. BJUI Compass. 2024. PMID: 39744071 Free PMC article.

Abstract

Objective: This study aims to investigate the impact of risk group classification, restaging transurethral resection (re-TURBT), and adjuvant treatment intensity on recurrence and progression risks in high-grade Ta tumours in patients with non-muscle invasive bladder cancer (NMIBC).

Materials and methods: Data from a comprehensive bladder cancer database were utilized for this study. Patients with primary high-grade Ta tumours were included. Risk groups were classified according to AUA/SUO criteria. Tumour characteristics and patient demographics were analysed using descriptive statistics. Cox proportional hazard regression models were used to assess the effect of re-TURBT and other clinical/treatment-related predictors on recurrence- and progression-free survivals. The survivals by selected predictors were estimated using Kaplan-Meier method, and groups were compared by the log-rank test.

Results: Among 218 patients with high-grade Ta bladder cancer, those who underwent re-TURBT had significantly better 5-year recurrence-free survival (71.1% vs. 26.8%, p = 0.0009) and progression-free survival (98.6% vs. 73%, p = 0.0018) compared with those with initial TURBT alone. Full BCG treatment (induction and maintenance) showed lower recurrence risk, especially in high-risk patients. However, residual disease at re-TURBT did not significantly affect recurrence risk.

Conclusions: This study highlights the significance of risk group classification, the role of re-TURBT, and the intensity of adjuvant treatment in the management of high-grade Ta tumours. A risk-adapted model is crucial to reduce the burden of unnecessary intravesical treatment and endoscopic procedures.

Keywords: non‐muscle invasive bladder cancer; progression‐free survival; recurrence‐free survival; restaging transurethral resection of bladder tumour.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

FIGURE 1
FIGURE 1
Kaplan–Meier curves for RFS, stratified by Risk group (A), Re‐TURBT (B), Adjuvant treatment (C), BCG modality (D; N = 162), and Risk group and BCG modality (E; N = 162).
FIGURE 2
FIGURE 2
Kaplan–Meier curves for PFS, stratified by Risk group (A), Re‐TURBT (B), and Adjuvant treatment (C).
See this image and copyright information in PMC

References

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