title: [Anamnesis, Pathological Assessment, Therapeutic Features and Course of Disease: Retrospective Study on Clinical-Based Factors for Prediction of Cancer-Specific Survival of 378 Patients with Stage pT1 Urothelial Bladder Carcinoma].
abstract: BACKGROUND
  Urothelial carcinoma of the bladder (UBC) at stage pT1 is a heterogenous disease. Established criteria for prognosis prediction are not suitable for every patient. Choosing the right therapeutic strategy for the individual patient thus remains a challenge. The aim of the present study was to identify clinical parameters regarding cancer-specific survival (CSS) in patients with pT1 UBC.
  
  
  METHODS
  A retrospective analysis of clinical parameters of all patients with a pT1 UBC between 1989 and 2012 from a single centre was performed. Treatment consisted of transurethral resection, second resection followed by initially bladder sparing treatment. Anamnestic data, histopathological reports and clinical course were assessed with CSS being defined as primary endpoint. Kaplan-Meier analysis, uni- and multivariate analysis were performed using SPSS (Version 22, IBM).
  
  
  RESULTS
  378 patients (78% male, median age 72 years) were included, median follow-up was 35 months. Pathological stage pT1G3 (66 vs. 91%, p<0.001), lack of instillation therapy (66 vs. 83%, p<0.001), presence of a second malignoma (41 vs. 77%, p=0,004), diagnosis after 2000 (75 vs. 76%, p=0,018) and tumour progress (42 vs. 85%, p<0.001) were associated with a worse CSS in univariate and Kaplan-Meier analysis. Multivariate analysis revealed the presence of a second malignoma (HR 2.267; CI 95% 1.143-4.497, p=0.019), pathological stage pT1G3 at initial diagnosis (HR 4.567; CI 95% 2.040-10.22, p<0.001) and tumour progress (HR 3.742; CI 95% 1.544-9.069, p=0.003) as independent negative predictors of CSS. Instillation therapy was a prognostic factor for improved CSS (HR 0.368; CI 95% 0.212-0.638, p<0.001).
  
  
  CONCLUSIONS
  The present study identified the presence of a second malignoma, pathological stage pT1G3 and tumour progress as negative predictive factors for CSS. Maintenance instillation therapy after reresection was associated with an improved CSS.
authors.affiliation: Klinik und Poliklinik für Urologie der Universität Regensburg, Caritas-Krankenhaus St. Josef, Regensburg.
authors.forename: J
authors.initials: J
authors.lastname: Breyer
authors.affiliation: Klinik und Poliklinik für Urologie der Universität Regensburg, Caritas-Krankenhaus St. Josef, Regensburg.
authors.forename: W
authors.initials: W
authors.lastname: Otto
authors.affiliation: Institut für Pathologie, Universität Erlangen-Nürnberg, Erlangen.
authors.forename: A
authors.initials: A
authors.lastname: Hartmann
authors.affiliation: Klinik und Poliklinik für Urologie der Universität Regensburg, Caritas-Krankenhaus St. Josef, Regensburg.
authors.forename: B
authors.initials: B
authors.lastname: Bumes
authors.affiliation: Klinik und Poliklinik für Urologie der Universität Regensburg, Caritas-Krankenhaus St. Josef, Regensburg.
authors.forename: J
authors.initials: J
authors.lastname: Bründl
authors.affiliation: Klinik und Poliklinik für Urologie der Universität Regensburg, Caritas-Krankenhaus St. Josef, Regensburg.
authors.forename: M
authors.initials: M
authors.lastname: Gierth
authors.affiliation: Institut für Pathologie, Universität Erlangen-Nürnberg, Erlangen.
authors.forename: S
authors.initials: S
authors.lastname: Bertz
authors.affiliation: Klinik und Poliklinik für Urologie der Universität Regensburg, Caritas-Krankenhaus St. Josef, Regensburg.
authors.forename: S
authors.initials: S
authors.lastname: Denzinger
authors.affiliation: Klinik und Poliklinik für Urologie der Universität Regensburg, Caritas-Krankenhaus St. Josef, Regensburg.
authors.forename: M
authors.initials: M
authors.lastname: Burger
authors.affiliation: Klinik und Poliklinik für Urologie der Universität Regensburg, Caritas-Krankenhaus St. Josef, Regensburg.
authors.forename: E M
authors.initials: EM
authors.lastname: Lausenmeyer
mesh_terms: D000368:Aged; D002295:Carcinoma, Transitional Cell / Q000401:mortality / Q000473:pathology* / Q000601:surgery*; D003558:Cystoscopy; D018450:Disease Progression; D005260:Female; D006801:Humans; D008297:Male; D008487:Medical History Taking; D009367:Neoplasm Staging; D012189:Retrospective Studies; D016019:Survival Analysis; D001749:Urinary Bladder Neoplasms / Q000401:mortality / Q000473:pathology* / Q000601:surgery*