- Patients with high-grade nonmuscle-invasive bladder cancer (NMIBC) treated with radical cystectomy (RC) before experiencing progression show superior survival vs those who progressed before or at RC.
- Tumor size and concomitant carcinoma in situ (CIS) at diagnosis were independent predictors of RC.
Why this matters
- Identifying predictive factors of RC can help select patients for early RC.
- Study of 2451 patients with high-grade NMIBC initially treated with Bacillus Calmette-Guerin (BCG).
- Funding: None.
- 20.8% of patients underwent RC.
- Patients with tumors ≥3 cm or CIS had earlier RC (HR, 1.75 and 1.64, respectively; both P<.001>
- Patients undergoing RC before progression showed superior survival vs those who progressed before or at RC (82% vs 47% and 60%, respectively; P<.001>
- In patients who progressed either before or at surgery (n=337), timing of RC was not associated with risk for progression at RC (HR, 1.19; P=.27).
- Patients with tumors ≥3 cm or multiple tumors (HR, 1.71 [P=.002] and 1.79 [P=.001], respectively) and those with tumors ≥3 cm or concomitant CIS (HR, 1.79 [P=.001] and 1.53 [P=.02], respectively) had earlier T3/T4 or N+ cystectomies.
- Patients with T3/T4 or N+ disease or CIS at cystectomy had shorter disease-specific survival (HR, 4.38 and 2.39; both P<.001>
- Retrospective design.