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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

Bobjer, Johannes LU ; Hagberg, Oskar LU ; Aljabery, Firas ; Gårdmark, Truls ; Jahnson, Staffan ; Jerlström, Tomas ; Sherif, Amir ; Ströck, Viveka ; Häggström, Christel and Holmberg, Lars LU , et al. (2021) In Scandinavian Journal of Urology 55(2). p.108-115
Abstract

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... (More)

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.

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organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Bladder cancer, second look resection, T1, transurethral resection
in
Scandinavian Journal of Urology
volume
55
issue
2
pages
8 pages
publisher
Taylor & Francis
external identifiers
  • scopus:85102237572
  • pmid:33678124
ISSN
2168-1805
DOI
10.1080/21681805.2021.1892179
language
English
LU publication?
yes
id
ffa06b13-81a3-4d57-afd2-a90cca1eb707
date added to LUP
2021-03-29 10:19:53
date last changed
2024-06-15 08:40:40
@article{ffa06b13-81a3-4d57-afd2-a90cca1eb707,
  abstract     = {{<p>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 &lt; 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.</p>}},
  author       = {{Bobjer, Johannes and Hagberg, Oskar and Aljabery, Firas and Gårdmark, Truls and Jahnson, Staffan and Jerlström, Tomas and Sherif, Amir and Ströck, Viveka and Häggström, Christel and Holmberg, Lars and Liedberg, Fredrik}},
  issn         = {{2168-1805}},
  keywords     = {{Bladder cancer; second look resection; T1; transurethral resection}},
  language     = {{eng}},
  number       = {{2}},
  pages        = {{108--115}},
  publisher    = {{Taylor & Francis}},
  series       = {{Scandinavian Journal of Urology}},
  title        = {{A population-based study on the effect of a routine second-look resection on survival in primary stage T1 bladder cancer}},
  url          = {{http://dx.doi.org/10.1080/21681805.2021.1892179}},
  doi          = {{10.1080/21681805.2021.1892179}},
  volume       = {{55}},
  year         = {{2021}},
}