Mp63-15 t1 sub-staging is associated with worse oncological outcomes for patients treated with bacillus calmette-guerin or immediate radical cystectomy.

You have accessJournal of UrologyCME1 Apr 2023MP63-15 T1 SUB-STAGING IS ASSOCIATED WITH WORSE ONCOLOGICAL OUTCOMES FOR PATIENTS TREATED WITH BACILLUS CALMETTE-GUERIN OR IMMEDIATE RADICAL CYSTECTOMY. Roberto Contieri, Wei Shen Tan, Valentina Grajales, Kelly Bree, Patrick Hensley, Charles C. Guo, Neema Navai, Colin P. Dinney, and Ashish M. Kamat Roberto ContieriRoberto Contieri More articles by this author , Wei Shen TanWei Shen Tan More articles by this author , Valentina GrajalesValentina Grajales More articles by this author , Kelly BreeKelly Bree More articles by this author , Patrick HensleyPatrick Hensley More articles by this author , Charles C. GuoCharles C. Guo More articles by this author , Neema NavaiNeema Navai More articles by this author , Colin P. DinneyColin P. Dinney More articles by this author , and Ashish M. KamatAshish M. Kamat More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003321.15AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: T1 sub-staging has been demonstrated to be of prognostic value in patients with NMIBC treated with intravesical therapy. However, it remains underutilized and has not been included in risk group stratification systems. Herein, we sought to evaluate the prognostic value of T1 substaging in patients treated with Bacillus Calmette-Guerin (BCG) or immediate radical cystectomy (iRC). METHODS: We performed an IRB approved retrospective study analyzing NMIBC patients with pT1 disease treated with either BCG or iRC between 2000 and 2020. Lamina propria (LP) invasion characteristics were classified to either: 1) focal and/or superficial (FS), 2) extensive and/or multifocal (EM), or 3) not specified. Cox regression models, adjusted for tumor and patient characteristics, were used to predict CSS, MFS and PFS. Logistic regression model was used to predict stage >T2 at iRC. RESULTS: A total of 411 T1 HG patients were identified; focal/superficial and extensive/multifocal LP invasion was found in 147 (35.8%) and 149 (36.2%) patients, respectively. Characteristics of LP invasion were not specified in 115 (28%) cases. EM LP invasion was a predictor of both CSS (Hazard ratio (HR): 5.38, 95% CI: 1.8-16.1, p=0.003) and MFS (HR:3.60, 95% CI: 1.51-8.53, p=0.004). Overall, 303 received BCG and 108 underwent iRC. Median follow-up was 49.4 months. Patients with EM LP invasion were significantly more likely to receive iRC (34% vs. 19% p=0.003). Among patients treated with iRC, stage ≥T2 was identified in 21 (19%). T1 substaging was independently associated with upstage at RC (OR: 4.71, 95% CI: 1.06-20.8, p=0.04). Among BCG-treated patients, progression occurred in 41 (13.5%) individuals. EM LP invasion again emerged as an independent predictor of progression after BCG at MV analysis (HR: 5.07, 95% CI: 2-12.55, p<0.001). CONCLUSIONS: Patients with extensive/multifocal LP invasion have poorer CSS and MFS whether treated with BCG or iRC. T1 substaging provides valuable prognostic information and should be reported in pathology reports. Source of Funding: This research was supported by the Wayne B. Duddlesten Professorship in Cancer Research, the Raymond and Maria Floyd Bladder Cancer Research Foundation Grant, NIH/NCI UTMD Anderson SPORE in Genitourinary Cancer (p50CA091846), the Cancer Center Support Grant (NCI Grant P30 CA016672) © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e877 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Roberto Contieri More articles by this author Wei Shen Tan More articles by this author Valentina Grajales More articles by this author Kelly Bree More articles by this author Patrick Hensley More articles by this author Charles C. Guo More articles by this author Neema Navai More articles by this author Colin P. Dinney More articles by this author Ashish M. Kamat More articles by this author Expand All Advertisement PDF downloadLoading ...