Key Strategies for Reducing Recurrence in T1 Bladder Cancer. Evidence from a Retrospective Multicenter European Study

Overview

Journal Int Urol Nephrol

Publisher Springer

Specialty Nephrology

Date 2025 Feb 11

PMID 39934553

Authors

Roberto Contieri

Alexandre Guigui

Bastien Gondran-Tellier

Giuseppe Basile

Fabio Zattoni

Andrea Gallioli

Paolo Verri

Julia Aumatell

Eric Lechevallier

Cyrille Bastide

Akram Akiki

Harry Toledano

Marco Moschini

Daniele Amparore

Laura S Mertens

Benjamin Pradere

Pawel Rajwa

Jeremy Y C Teoh

Francesco Porpiglia

Alberto Breda

Francesco Montorsi

Michael Baboudjian

Alessandro Uleri

Affiliations

Soon will be listed here.

Abstract

Introduction: To evaluate whether adherence to specific quality criteria in the management of T1 non-muscle-invasive bladder cancer (NMIBC) undergoing second-look transurethral resection of bladder tumor (TURBT) leads to improved oncological outcomes.

Materials And Methods: A retrospective multicenter study included patients diagnosed between 2015 and 2021 with high or very-high-risk a NMIBC after initial TURBT, followed by second-look TURBT and Bacillus Calmette-Guérin (BCG) adjuvant therapy. Key management steps assessed included enhanced tumor visualization, complete resection, timing of second look, detrusor muscle presence in specimens, and adequate BCG therapy. The primary endpoint was bladder recurrence-free survival (RFS), analyzed using Kaplan-Meier curves and Cox regression models.

Results: Among 226 patients included, the median age was 73(65-79) years, and 49 were classified in the very high-risk group (22%). Second-look TURBT was performed with a median delay of 8 (6-10) weeks. Factors significantly impacting 3-year RFS included adequate BCG exposure (HR = 0.55; 95% CI 0.32-0.93; p = 0.03) and the presence of residual tumor at second-look TURBT (HR = 2.55; 95% CI 1.48-4.39; p < 0.001). Neither the use of photodynamic diagnostics nor timing beyond 6 weeks for second-look TURBT significantly influenced outcomes (p > 0.05).

Conclusions: In T1 NMIBC, adequate BCG therapy and absence of residual tumor at second-look TURBT are the primary predictors of 3-year RFS. These findings emphasize the importance of quality management in TURBT procedures and patient treatment.

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