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A population-based study on the effect of a routine second-look resection on survival in primary stage T1 bladder cancer
Department of Urology, Skåne University Hospital, Malmö, Sweden; Institution of Translational Medicine, Lund University, Malmö, Sweden.
Institution of Translational Medicine, Lund University, Malmö, Sweden.
Department of Clinical and Experimental Medicine, Division of Urology, Linköping University, Linköping, Sweden.
Department of Clinical Sciences, Danderyd Hospital, Karolinska Institute, Stockholm, Sweden.
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2021 (English)In: Scandinavian journal of urology, ISSN 2168-1805, E-ISSN 2168-1813, Vol. 55, no 2, p. 108-115Article in journal (Refereed) Published
Abstract [en]

OBJECTIVE: To assess the value of second-look resection (SLR) in stage T1 bladder cancer (BCa) with respect to progression-free survival (PFS), and also the secondary outcomes recurrence-free survival (RFS), bladder-cancer-specific survival (CSS), and cystectomy-free survival (CFS).

PATIENTS AND METHODS: The study included 2456 patients diagnosed with stage T1 BCa 2004-2009 with 5-yr follow-up registration in the nationwide Bladder Cancer Data Base Sweden (BladderBaSe). PFS, RFS, CSS, and CFS were evaluated in stage T1 BCa patients with or without routine SLR, using univariate and multivariable Cox regression with adjustment for multiple confounders (age, gender, tumour grade, intravesical treatment, hospital volume, comorbidity, and educational level).

RESULTS: SLR was performed in 642 (26%) individuals, and more frequently on patients who were aged < 75 yr, had grade 3 tumours, and had less comorbidity. There was no association between SLR and PFS (hazard ratio [HR] 1.1, confidence interval [CI] 0.85-1.3), RFS (HR 1.0, CI 0.90-1.2), CFS (HR 1.2, CI 0.95-1.5) or CSS (HR 1.1, CI 0.89-1.4).

CONCLUSIONS: We found similar survival outcomes in patients with and patients without SLR, but our study is likely affected by selection mechanisms. A randomised study defining the role of SLR in stage T1 BCa would be highly relevant to guide current praxis.

Place, publisher, year, edition, pages
Taylor & Francis, 2021. Vol. 55, no 2, p. 108-115
Keywords [en]
Bladder cancer, T1, second look resection, transurethral resection
National Category
Cancer and Oncology
Identifiers
URN: urn:nbn:se:oru:diva-90323DOI: 10.1080/21681805.2021.1892179ISI: 000626037300001PubMedID: 33678124Scopus ID: 2-s2.0-85102237572OAI: oai:DiVA.org:oru-90323DiVA, id: diva2:1535933
Funder
Swedish Cancer Society, CAN 2019/62 CAN 2017/278
Note

Funding Agencies:

Lund Medical Faculty (ALF)  

Skåne University Hospital Research Funds

Gyllenstierna Krapperup's Foundation  

Cancer Research Fund at Malmö General Hospital  

Stiftelsen Sigurd och Elsa Goljes Minne  Bergqvist Foundation  

Skåne County Council's Research and Development Foundation REGSKANE622351

Gösta Jonsson Research Foundation  

Foundation of Urological Research  

Hillevi Fries Research Foundation 

Available from: 2021-03-09 Created: 2021-03-09 Last updated: 2021-12-21Bibliographically approved

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Jerlström, Tomas

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