- Journal
- FRENCH JOURNAL OF UROLOGY
- Année
- 2025
- Volume
- 35
- Numéro
- 3
- Article
- 102838
- Mois
- APR
- DOI
- 10.1016/j.fjurol.2024.102838
Abstract
Introduction: High-grade non-muscle invasive bladder cancer (HG-NMIBC) exposes to a high risk of recurrence and progression. Standard of care includes repeated trans-urethral resection of bladder tumor (reTURBT) and bacillus Calmette-Guerin (BCG) therapy. Not following Standard of care (SOC) may be associated with a worse prognosis. We aimed to compare prognosis outcomes of patients with primary HG-NMIBC according to the respect of the SOC or not. Materials and methods: We conducted an eleven-year retrospective observational study including all patients undergoing initial bladder resection for de novo HG-NMIBC at our institution. Exclusion criteria were prior urothelial carcinoma histology, low grade NMIBC or > T2 staging. Four groups were formed according to the treatment received. Results: Among 164 patients, 44.5% received standard of care, 18.3% received only BCG-therapy, 16.5% benefited only from reTURBT and 20.7% did not receive treatment. Upstaging to T2 tumor was found in 6% of reTURBT specimens. Presence of residual tumor (RT) on re-TURBT (P < 10-4) and having benefited from SOC (P = 0.016) impacted recurrence-free survival. Progression-free survival was impacted by presence of RT (P = 0.001) but not by SOC (P = 0.284). Conclusion: Performing standard of care on patients with HG-NMIBC is associated with a lower risk of recurrence. We believe SOC should be provided for all HG-NMIBC patients, especially those with poor prognostic factors such as T1 tumor, or multiplicity or largeness of the bladder tumor. Level of evidence: 4. (c) 2024 Elsevier Masson SAS. All rights are reserved, including those for text and data mining, AI training, and similar technologies.