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23 januari 2025: Bron: International Journal of Radiation Oncology

Wanneer bij blaaskankerpatiënten zonder uitzaaiingen vooraf aan de bestraling / radiotherapie een volledige of niet volledige TURTB - Transurethrale tumorresectie blaas is uitgevoerd maakt dat uiteindelijk op de 5-jaarsoverleving en ziektevrije tijd weinig tot geen verschil. Zo blijkt uit een grote langjarige Canadese studie in 10 ziekenhuizen bij totaal 757 blaaskankerpatiënten.

Hier de vertaling van de resultaten zoals in het abstract weergegeven:

  • Van de 757 opgenomen patiënten had 66% (498 patiënten) documentatie van een complete en 34% (259 patiënten) een incomplete TURBT.
  • Vóór aanpassing kregen respectievelijk 121 patiënten (47%) en 45 patiënten (9%) die een incomplete en complete TURBT ondergingen, de diagnose cT3-4-tumor (P <.001).
  • Na gewichtsaanpassing waren alle baseline cohortkenmerken in evenwicht (absolute gestandaardiseerde verschillen < 0,1).
  • De gecorrigeerde mediane follow-up van de studie was 27 maanden.
  • Gecorrigeerde overlevingsanalyses lieten geen significant verschil zien in de algehele overleving na 5 jaar (48% versus 52%, 1,03 [0,82-1,29]; P = .8), kankerspecifieke overleving (64% versus 61%, 0,93 [0,70-1,25]; P = .7), metastasenvrije overleving (43% versus 46%, 0,97 [0,79-1,19]; P = .8) en ziektevrije overleving (32% versus 35%, 0,95 [0,79-1,15]; P = .7) tussen de 2 groepen.

Fig 1


Fig. 1 Kaplan-Meier estimates of OS (a, b), CSS (c, d), MFS (e, f), and DFS (g, h) stratified by the extent of TURBT before and after IPTW adjustment. Abbreviations: CSS = cancer-specific survival; DFS = disease-free survival; IPTW = inverse probability of treatment weighting; MFS = metastasis-free survival; OS = overall survival; TURBT = transurethral tumor resection.

De onderzoekers concluderen dan ook dat een volledige TURTB - Transurethrale tumorresectie blaas  geassocieerd kan worden met klinische orgaanbeperkte ziekte. De mate van TURBT was niet onafhankelijk geassocieerd met oncologische uitkomsten bij patiënten met niet uitgezaaide blaaskanker die behandeld werden met radiotherapie / bestraling ter preventie van een recidief.

Het volledige studierapport is gratis in te zien. Klik daarvoor op de titel van het abstract:

Abstract

Purpose

To compare the oncologic outcomes of patients with nonmetastatic muscle-invasive bladder cancer (MIBC) undergoing complete versus incomplete transurethral tumor resection (TURBT) before radiation therapy.

Methods and Materials

Patients with nonmetastatic MIBC who underwent curative-intent radiation therapy between 2002 and 2018 at 10 Canadian institutions were retrospectively evaluated. Inverse probability of treatment weighting was performed using baseline characteristics. Differences in survival outcomes by complete and incomplete TURBT were analyzed.

Results

Of the 757 patients included, 66% (498) had documentation of a complete and 34% (259) an incomplete TURBT. Before adjustment, 121 (47%) and 45 (9%) patients who underwent incomplete and complete TURBT, respectively, were diagnosed with cT3-4 tumor (P <.001). After weight-adjustment, all baseline cohort characteristics were balanced (absolute standardized differences < 0.1). The adjusted median follow-up was 27 months. Adjusted survival analyses showed no significant difference in 5-year overall survival (48% vs 52%, 1.03 [0.82-1.29]; P = .8), cancer-specific survival (64% vs 61%, 0.93 [0.70-1.25]; P = .7), metastasis-free survival (43% vs 46%, 0.97 [0.79-1.19]; P = .8), and disease-free survival (32% vs 35%, 0.95 [0.79-1.15]; P = .7) between the 2 groups.

Conclusions

Complete TURBT may be associated with clinical organ-confined disease. Extent of TURBT was not independently associated with oncologic outcomes in patients with MIBC treated with radiation therapy.



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