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Vignesh T. Packiam Craig V. Labbate Stephen A. Boorjian Robert Tarrell John C. Cheville Svetlana Avulova Vidit Sharma Matvey Tsivian Brittany Adamic Mohammad Mahmoud Ryan P. Werntz Norm D. Smith R. Jeffrey Karnes Matthew K. Tollefson Gary D. Steinberg Igor Frank 《Urologic oncology》2021,39(7):436.e1-436.e8
IntroductionWhile numerous current clinical trials are testing novel salvage therapies (ST) for patients with recurrent nonmuscle invasive bladder cancer (NMIBC) after bacillus Calmette-Guérin (BCG), the natural history of this disease state has been poorly defined to date. Herein, we evaluated oncologic outcomes in patients previously treated with BCG and ST who subsequently underwent radical cystectomy (RC).MethodsWe identified 378 patients with high-grade NMIBC who received at least one complete induction course of BCG (n = 378) with (n = 62) or without (n = 316) additional ST and who then underwent RC between 2000 and 2018. Oncologic outcomes were compared using the Kaplan-Meier method and Cox proportional hazards models. Sensitivity analyses were conducted stratifying by presenting tumor stage, matched 1:3 for receipt vs. no receipt of ST.ResultsPatients receiving ST were more likely to initially present with CIS (26% vs. 17%) and less likely with T1 disease (34% vs. 50%, P = 0.06) compared to patients not treated with ST. Receipt of ST was not associated with increased risk of adverse pathology (≥pT2 or pN+) at RC (31% vs. 41%, P = 0.14). Likewise, 5-year cancer-specific survival did not significantly differ between groups on univariable Kaplan-Meier analysis (73% for ST and 74% for no ST, P = 0.7). Moreover, on multivariable analysis, receipt of ST was not significantly associated the risk of death from bladder cancer (HR 1.12; 95% CI 0.60–2.09, P = 0.7). Results were unchanged on sensitivity analysis.ConclusionsThese data suggest that, in carefully selected patients, ST following BCG for high grade NMIBC does not compromise oncologic outcomes for patients who ultimately undergo RC. 相似文献
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Lapin Brittany R. Thompson Nicolas R. Schuster Andrew Honomichl Ryan Katzan Irene L. 《Quality of life research》2021,30(6):1735-1745
Quality of Life Research - Caregivers, or proxies, often complete patient-reported outcome measures (PROMs) on behalf of patients with stroke. The objective of our study was to assess the validity... 相似文献
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Brittany C. Thomas Stephen N. Thibodeau Noralane M. Lindor 《Current colorectal cancer reports》2005,1(2):103-109
Referrals to genetics services are becoming increasingly common for patients who are diagnosed with early-onset colorectal
cancer (CRC) or patients who have a family history of CRC. Microsatellite instability (MSI) testing and immunohistochemical
analysis (IHC) of the patient’s tumor tissue, which assess indirectly the cellular status of DNA mismatch repair, have proven
important tools for geneticists and genetic counselors to determine whether or not these individuals may be at risk for an
inherited cancer syndrome, Lynch syndrome (a subset of hereditary nonpolyposis colorectal cancer). The application of tumor
MSI/ IHC also extends to the group of providers involved in the diagnosis and management of CRC, demonstrating the growing
clinical applicability of MSI/IHC testing. This review discusses the clinical utility of MSI/IHC analysis, including its benefits
and limitations, and addresses some of the current debates surrounding testing. 相似文献
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