Aarhus, Denmark (UroToday.com) Dr. FC De Jong of the Erasmus MC Cancer Institute in Rotterdam discussed his group’s efforts in performing advanced pathologic T1 sub staging to improve the identification of high-risk non-muscle invasive bladder cancer patients who may be at risk for Bacillus Calmette-Guerin (BCG)-failure. Patients treated with TURBT and BCG between 2000 and 2016 were identified, and a central review of all primary and subsequent TURs was performed.

Tumors were classified as either T1 micro (T1m) or extensive (T1e), and the endpoint of BCG-failure as defined by the EAU guidelines were used as a primary endpoint. Following an analysis of 513 patients, pT1e on primary TUR was found to be associated with BCG-failure (HR 2.1, p=0.023). The risk of progression at first recurrence was also increased with pT1e (HR 5.9, p<0.001). Dr. de Jong concluded that the use of T1 substaging by pathologists could offer improved risk stratification for patients with T1 HG bladder cancer.



Abstract take-home message:

  • Use of pathologic T1 substaging methods to describe T1-micro (single stromal invasive focus) versus T1-extensive (multiple stromal foci or >=0.5 mm stromal invasion) may provide additional prognostic value in identifying patients at risk for BCG failure (per EAU guidelines)

Presented by: FC De Jong, Prof MD Ph.D., of the Erasmus MC Cancer Institute in Rotterdam, The Netherlands

Written by Dr. Vikram M. Narayan (@VikramNarayan), Urologic Oncology Fellow with Ashish M. Kamat, MD (@UroDocAsh), Professor, Department of Urology, Division of Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX at the 17th meeting of the International Bladder Cancer Network, (IBCN, #IBCN2019) October 3rd – 5th, 2019 in Aarhus, Denmark.