The aim of our multicenter study is to investigate the role of age in the oncologic outcomes of carcinoma in situ (CIS) of the bladder. One hundred and seventy-two patients with CIS from 8 centers were analyzed. Patients > 70 years reported a lower recurrence free survival and progression free survival compared to younger patients, respectively 41.7% versus 60%, and 68.3% versus 86.04%. Introduction: The aim of this multicenter study was to investigate the role of age (cut-off 70 years) at diagnosis in predicting oncologic behavior of pure carcinoma in situ of the bladder. Material and Methods: Inclusion cr iter ia were: patients with pure CIS confirmed and that followed intravesical BCG treatment. Pure CIS was defined at any CIS not associated with another urothelial cancer. Exclusion cr iter ia were: any CIS associated with invasive urothelial carcinoma. A total of 172 with pure CIS treated between January 1, 2002 and December 31, 2012 at 8 academic institutions met the inclusion cr iter ia. The maintenance schedule was generally according to the EAU guidelines at the time Results: A total of 99 (57.6%) patients had an age > 70 years prior to TURBT. There was no difference between clinico-pathologic features among groups (group 1, age < 70 years and group 2, age > 70 years), except that patients aged < 70 years presented a larger size of CIS (35.6% vs. 21.2%), P = .02. In multivariable Cox regression analyses, the same clinicopathologic factors (age, multifocality, and recurrent tumor state) were independently associated with worse RFS. Harrell's C-index was 65.75.In multivariable Cox regression analyses in addition to age ( P = .006) and multifocality ( P < .001) also BMI ( P = .04) was independently associated with worse PFS. Harrell's C-index was 74.71 Conclusion: Advanced age at diagnosis appears to be associated with an increased risk of recurrence and progression of pure carcinoma in situ of the bladder. Elderly patients might fail to respond to BCG therapy.

Impact of Age on Outcomes of Patients With Pure Carcinoma In Situ of the Bladder: Multi-Institutional Cohort Analysis / M. Ferro, S. Chiujdea, G. Musi, G. Lucarelli, F. Del Giudice, R. Hurle, R. Damiano, F. Cantiello, A. Mari, A. Minervini, G.M. Busetto, G. Carrieri, F. Crocetto, B. Barone, V.F. Caputo, L. Cormio, P. Ditonno, A. Sciarra, D. Terracciano, A. Cioffi, S. Luzzago, M. Piccinelli, F.A. Mistretta, M.D. Vartolomei, O. de Cobelli. - In: CLINICAL GENITOURINARY CANCER. - ISSN 1938-0682. - 20:2(2022 Apr), pp. e166-e172. [10.1016/j.clgc.2021.12.005]

Impact of Age on Outcomes of Patients With Pure Carcinoma In Situ of the Bladder: Multi-Institutional Cohort Analysis

G. Musi;A. Cioffi;S. Luzzago;M. Piccinelli;F.A. Mistretta;O. de Cobelli
Ultimo
2022

Abstract

The aim of our multicenter study is to investigate the role of age in the oncologic outcomes of carcinoma in situ (CIS) of the bladder. One hundred and seventy-two patients with CIS from 8 centers were analyzed. Patients > 70 years reported a lower recurrence free survival and progression free survival compared to younger patients, respectively 41.7% versus 60%, and 68.3% versus 86.04%. Introduction: The aim of this multicenter study was to investigate the role of age (cut-off 70 years) at diagnosis in predicting oncologic behavior of pure carcinoma in situ of the bladder. Material and Methods: Inclusion cr iter ia were: patients with pure CIS confirmed and that followed intravesical BCG treatment. Pure CIS was defined at any CIS not associated with another urothelial cancer. Exclusion cr iter ia were: any CIS associated with invasive urothelial carcinoma. A total of 172 with pure CIS treated between January 1, 2002 and December 31, 2012 at 8 academic institutions met the inclusion cr iter ia. The maintenance schedule was generally according to the EAU guidelines at the time Results: A total of 99 (57.6%) patients had an age > 70 years prior to TURBT. There was no difference between clinico-pathologic features among groups (group 1, age < 70 years and group 2, age > 70 years), except that patients aged < 70 years presented a larger size of CIS (35.6% vs. 21.2%), P = .02. In multivariable Cox regression analyses, the same clinicopathologic factors (age, multifocality, and recurrent tumor state) were independently associated with worse RFS. Harrell's C-index was 65.75.In multivariable Cox regression analyses in addition to age ( P = .006) and multifocality ( P < .001) also BMI ( P = .04) was independently associated with worse PFS. Harrell's C-index was 74.71 Conclusion: Advanced age at diagnosis appears to be associated with an increased risk of recurrence and progression of pure carcinoma in situ of the bladder. Elderly patients might fail to respond to BCG therapy.
Aging; Bladder cancer; Oncological outcomes; Progression; Recurrence
Settore MED/24 - Urologia
apr-2022
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/2434/951475
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