Tissot Gabrielle, Gabriel Pierre-Etienne, Dubuet Ulysse, Régnier Sophie, Ouzaid Idir, Moschini Marco, Soria Francesco, D'Andrea David, Shariat Shahrokh F, Budowski Alexandra, Poyet Cédric, Roumiguie Mathieu, Maestro Mario Alvarez, Briganti Alberto, Krajewski Wojciech, Hendricksen Kees, Veerman Hans, Afferi Luca, Mattei Agostino, Di Bona Carlo, Zamboni Stefania, Simeone Claudio, Thenault Ronan, Verhoest Gregory, Hermieu Jean-François, Xylinas Evanguelos
Department of Urology, Assistance Publique-Hôpitaux de Paris Nord, Bichat Claude-Bernard Hospital, University Paris Cité, Paris, France.
Unit of Urology, Division of Oncology, Urological Research Institute, IRCCS Ospedale San Raffaele, Milan, Italy.
World J Urol. 2025 May 26;43(1):324. doi: 10.1007/s00345-025-05669-3.
To evaluate the impact of detrusor muscle (DM) absence on oncological outcomes in patients with pTaHG within a large, multicenter cohort.
This is a retrospective multicenter study based on a national database including 12 international expert centers. All patients who underwent transurethral resection of bladder tumor (TURBT) for a new diagnosis of pTaHG bladder cancer between January 2010 and December 2018 were included and divided into two groups according to the presence or absence of DM. Kaplan-Meier curves were used to illustrate survival outcomes, while Cox regression analyses were conducted to identify independent predictors of survival.
Overall, 418 patients had either pTaHG with DM (n = 365;87.3%) or without DM (n = 53;12.7%). After a median follow-up of 30 months, IQR [15;55], the 5-year RFS (40% vs. 50%; p = 0.2) and the 5-year PFS (75% vs. 86%; p = 0.2) were similar between both groups. Cox-regression analysis confirmed that absence of DM was not significantly associated with RFS (HR = 0.68; 95%CI= [0.41-1.15]; p = 0.15) and PFS (HR = 0.68; 95%CI= [0.27-1.69]; p = 0.40). Among 53 patients without DM, 29 (54.7%) underwent a second-look TURBT, with no impact on 5-year RFS (p = 0.1) and 5-year PFS (p = 0.07). Additionally, Cox-regression analysis confirmed that the absence of second-look was not associated with RFS (HR = 0.28; 95%CI= [0.09-0.93]; p = 0.04) and PFS (HR = 0.05; 95%CI= [0.00-0.89]; p = 0.04).
Absence of DM on pathological specimen of pTaHG tumors had no impact on disease recurrence or progression occurrence, calling into question the need for routine second-look procedures for these patients.
在一个大型多中心队列中评估逼尿肌（DM）缺失对pTaHG患者肿瘤学结局的影响。
这是一项基于国家数据库的回顾性多中心研究，该数据库包括12个国际专家中心。纳入2010年1月至2018年12月期间因新诊断为pTaHG膀胱癌而接受经尿道膀胱肿瘤切除术（TURBT）的所有患者，并根据是否存在DM将其分为两组。采用Kaplan-Meier曲线来说明生存结局，同时进行Cox回归分析以确定生存的独立预测因素。
总体而言，418例患者患有伴DM的pTaHG（n = 365；87.3%）或不伴DM的pTaHG（n = 53；12.7%）。中位随访30个月，四分位间距[15；55]，两组间5年无复发生存率（RFS）（40%对50%；p = 0.2）和5年无进展生存率（PFS）（75%对86%；p = 0.2）相似。Cox回归分析证实，DM缺失与RFS（风险比[HR]= 0.68；95%置信区间[CI]= [0.41 - 1.15]；p = 0.15）和PFS（HR = 0.68；95%CI= [0.27 - 1.69]；p = 0.40）均无显著相关性。在53例无DM的患者中，29例（54.7%）接受了二次TURBT，对5年RFS（p = 0.1）和5年PFS（p = 0.07）无影响。此外，Cox回归分析证实，未进行二次手术与RFS（HR = 0.28；95%CI= [0.09 - 0.93]；p = 0.04）和PFS（HR = 0.05；95%CI= [0.00 - 0.89]；p = 0.04）均无相关性。
pTaHG肿瘤病理标本中DM缺失对疾病复发或进展的发生没有影响，这使人质疑这些患者进行常规二次手术的必要性。
