MILAN—Bladder neck tumors and the presence of multiple tumors at the diagnosis of muscle-invasive bladder cancer (MIBC) are risk factors for the recurrence of intravesical tumors in patients treated with selective bladder-sparing approaches, according to a Japanese study presented at the 28th annual congress of the European Association of Urology.
The study, by Fumitaka Koga, MD, and collaborators at the Tokyo Medical and Dental University Graduate School, included 98 bladder-preserved patients who had achieved tumor-free status after induction chemoradiotherapy (CRT) for cT2-3N0M0 bladder cancer.
Of these, 64 went on to undergo partial cystectomy. After a median follow-up of 50 months, 21 of these patients experienced recurrence of intravesical tumors, which translated into a five-year cumulative bladder tumor recurrence rate of 27%. MIBC recurrence developed in four of the 21 patients, for a five-year cumulative recurrence rate of 4%.
After accounting for multiple variables, bladder neck tumors and multiple tumors at MIBC diagnosis each was independently and significantly associated with a fivefold and fourfold increased risk of intravesical bladder tumor recurrence, respectively. At five years from CRT, the cumulative incidence of tumor recurrence 18% for patients without either risk factor, 28% for those with one risk factor, and 78% for those with both risk factors.
The five-year overall and cancer-specific survival rate for the 98 patients in the study group was 84% and 92%, respectively. The study found no significant difference in cancer-specific survival between the 21 patients with recurrent tumors and the patients who did not experience recurrence (88% and 93%, respectively).