The existence and prognosis of T1LG (T1 low-grade) bladder cancer is controversial. Also, because of data paucity, it remains unclear what is the clinical history of bacillus Calmette-Guérin (BCG) treated T1LG tumors and if it differs from other NMIBC (non-muscle-invasive bladder cancer) representatives. The aim of this study was to analyse recurrence-free survival (RFS) and progression-free survival (PFS) in patients with T1LG bladder cancers treated with BCG immunotherapy.
A multi-institutional and retrospective study of 2510 patients with Ta/T1 NMIBC with or without carcinoma in situ (CIS) treated with BCG (205 T1LG patients) was performed. Kaplan-Meier estimates and log-rank test for RFS and PFS to compare the survival between TaLG, TaHG, T1LG, and T1HG NMIBC were used. Also, T1LG tumors were categorized into EAU2021 risk groups and PFS analysis was performed, and Cox multivariate model for both RFS and PFS were constructed.
The median follow-up was 52 months. For the T1LG cohort, the estimated RFS and PFS rates at 5-year were 59.3% and 89.2%, respectively. While there were no differences in RFS between NMIBC subpopulations, a slightly better PFS was found in T1LG NMIBC compared to T1HG (5-year PFS; T1LG vs. T1HG: 82% vs. 89%; P<0.001). A heterogeneous classification of patients with T1LG NMIBC was observed when EAU 2021 prognostic model was applied, finding a statistically significant worse PFS in patients classified as high-risk T1LG (5-year PFS; 81.8%) compared to those in intermediate (5-year PFS; 93,4%), and low-risk T1LG tumors (5-year PFS; 98,1%).
The RFS of T1LG was comparable to other NMIBC subpopulations. The PFS of T1LG tumors was significantly better than of T1HG NMIBC. The EAU2021 scoring model heterogeneously categorized the risk of progression in T1LG tumors and the high-risk T1LG had the worst PFS.
Minerva urology and nephrology. 2023 Oct [Epub]
Radosław Piszczek, Wojciech Krajewski, Jose D Subiela, Francesco Del Giudice, Łukasz Nowak, Joanna Chorbińska, Marco Moschini, Alexandra Masson-Lecomte, Sonia Bebane, Alessia Cimadamore, Elisabeth Grobet-Jeandin, Morgan Rouprêt, David D'Andrea, Riccardo Mastroianni, Beatriz Gutierrez Hidalgo, Juan Gomez Rivas, Keiichiro Mori, Francesco Soria, Ekaterina Laukhtina, Andrea Mari, Simone Albisinni, Andrea Gallioli, Laura S Mertens, Renate Pichler, Gautier Marcq, Jan Łaszkiewicz, Agnieszka Hałoń, Diego M Carrion, Murat Akand, Benjamin Pradere, Shahrokh F Shariat, Juan Palou, Marko Babjuk, Javier Burgos Revilla, Bartosz Małkiewicz, Tomasz Szydełko, European Association of Urology EAU-Young Academic Urologists YAU Urothelial Cancer Working Party
Department of Minimally Invasive Robotic Urology Center of Excellence in Urology, Wrocław Medical University, Wrocław, Poland., Department of Minimally Invasive Robotic Urology Center of Excellence in Urology, Wrocław Medical University, Wrocław, Poland - ., Department of Urology, Ramón y Cajal University Hospital, IRYCIS, University of Alcala, Madrid, Spain., Department of Urology, Umberto I Polyclinic Hospital, Sapienza University, Rome, Italy., Division of Experimental Oncology, Department of Urology, Urological Research Institute, Vita-Salute San Raffaele University, Milan, Italy., Department of Urology, Saint-Louis Hospital, APHP, Paris Cité University, Paris, France., Section of Pathological Anatomy, Polytechnic University of Marche, Ospedali Riuniti, Ancona, Italy., Department of Urology, Pitié-Salpêtrière Hospital, APHP, Sorbonne University, Paris, France., Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria., Department of Urology, IRCCS "Regina Elena" National Cancer Institute, Rome, Italy., Department of Urology, Hospital Clínico San Carlos, Madrid, Spain., Department of Urology, The Jikei University School of Medicine, Tokyo, Japan., Division of Urology, Department of Surgical Sciences, Molinette Hospital, University of Turin School of Medicine, Turin, Italy., Unit of Oncologic Minimally-Invasive Urology and Andrology, Department of Experimental and Clinical Medicine, Careggi University Hospital, University of Florence, Florence, Italy., Department of Urology, Erasme Hospital, University Clinics of Brussels, Free University of Brussels, Brussels, Belgium., Department of Urology, Puigvert Foundation, Autonomous University of Barcelona, Barcelona, Spain., Department of Urology, Netherlands Cancer Institute, Amsterdam, the Netherlands., Department of Urology, Medical University of Innsbruck, Innsbruck, Austria., Department of Urology, Claude Huriez Hospital, CHU Lille, Lille, France., Division of Clinical Pathology, Department of Clinical and Experimental Pathology, Wroclaw Medical University, Wrocław, Poland., Department of Urology, Torrejon University Hospital, Madrid, Spain., Department of Urology, University Hospitals Leuven, Leuven, Belgium., Department of Urology, Second Faculty of Medicine, Charles University, Prague, Czech Republic.