A population-based study on the effect of a routine second-look resection on survival in primary stage T1 bladder cancerShow others and affiliations
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
2021-03-092021-03-092021-12-21Bibliographically approved