S. Juste-Álvarez, C. García-Rayo Encina, C. Gómez del Cañizo, M. Hernández-Arroyo, N.R. Miranda Utrera, A. Rodríguez-Antolín, F. Guerrero-Ramos
{"title":"原发性和进行性肌肉侵袭性膀胱癌的预后比较:根治性膀胱癌切除术后的长期预后分析","authors":"S. Juste-Álvarez, C. García-Rayo Encina, C. Gómez del Cañizo, M. Hernández-Arroyo, N.R. Miranda Utrera, A. Rodríguez-Antolín, F. Guerrero-Ramos","doi":"10.1016/j.acuro.2025.501815","DOIUrl":null,"url":null,"abstract":"<div><h3>Introduction</h3><div>Up to 15% of muscle-invasive bladder cancers (MIBC) arise from the progression of a non-muscle-invasive neoplasm. Despite sharing similar treatment strategies, the literature reports differences in survival rates between these 2<!--> <!-->groups. This study aims to identify differences in recurrence and survival that may influence individualized treatment approaches.</div></div><div><h3>Material and methods</h3><div>Prospective study of cystectomies performed for MIBC between 2011 and 2023, collecting demographic, diagnostic, treatment, and recurrence data (local, urothelial, or distant). A comparative and multivariate analysis was conducted.</div></div><div><h3>Results</h3><div>We did not observe significant differences in recurrence rates between primary and progressive MIBC. However, the group with progression showed better overall survival (OS) rates at 2, 5 and 10 years (100%, 90%, 55%) compared to the primary (80%, 55%, 35%; <em>P</em> = 0.012), as well as better cancer-specific survival (CSS) (100%, 100%, 95% vs. 85%, 77%, 65%; <em>P</em> = 0.033). Independent risk factors for recurrence include pN<!--> <!-->+<!--> <!-->(OR: 3.72) and lymphovascular invasion (LVI) (OR: 5.53). Predictors of lower OS include age, nodal involvement, LVI and relapse at any level. For CSS, predictors include nodal involvement, LVI and relapse at any level.</div></div><div><h3>Conclusions</h3><div>In our series, patients with progressive MIBC have better OS and CSS. For both groups, pN<!--> <!-->+<!--> <!-->and LVI are independent risk factors for recurrence. Nodal involvement, LVI and relapse at any level are predictors of poorer OS and CSS.</div></div>","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"49 8","pages":"Article 501815"},"PeriodicalIF":1.2000,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Comparación del pronóstico entre carcinoma vesical musculoinvasivo primario y progresivo: análisis prospectivo de resultados a largo plazo tras cistectomía radical\",\"authors\":\"S. Juste-Álvarez, C. García-Rayo Encina, C. Gómez del Cañizo, M. Hernández-Arroyo, N.R. Miranda Utrera, A. Rodríguez-Antolín, F. Guerrero-Ramos\",\"doi\":\"10.1016/j.acuro.2025.501815\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Introduction</h3><div>Up to 15% of muscle-invasive bladder cancers (MIBC) arise from the progression of a non-muscle-invasive neoplasm. Despite sharing similar treatment strategies, the literature reports differences in survival rates between these 2<!--> <!-->groups. This study aims to identify differences in recurrence and survival that may influence individualized treatment approaches.</div></div><div><h3>Material and methods</h3><div>Prospective study of cystectomies performed for MIBC between 2011 and 2023, collecting demographic, diagnostic, treatment, and recurrence data (local, urothelial, or distant). A comparative and multivariate analysis was conducted.</div></div><div><h3>Results</h3><div>We did not observe significant differences in recurrence rates between primary and progressive MIBC. However, the group with progression showed better overall survival (OS) rates at 2, 5 and 10 years (100%, 90%, 55%) compared to the primary (80%, 55%, 35%; <em>P</em> = 0.012), as well as better cancer-specific survival (CSS) (100%, 100%, 95% vs. 85%, 77%, 65%; <em>P</em> = 0.033). Independent risk factors for recurrence include pN<!--> <!-->+<!--> <!-->(OR: 3.72) and lymphovascular invasion (LVI) (OR: 5.53). Predictors of lower OS include age, nodal involvement, LVI and relapse at any level. For CSS, predictors include nodal involvement, LVI and relapse at any level.</div></div><div><h3>Conclusions</h3><div>In our series, patients with progressive MIBC have better OS and CSS. For both groups, pN<!--> <!-->+<!--> <!-->and LVI are independent risk factors for recurrence. Nodal involvement, LVI and relapse at any level are predictors of poorer OS and CSS.</div></div>\",\"PeriodicalId\":7145,\"journal\":{\"name\":\"Actas urologicas espanolas\",\"volume\":\"49 8\",\"pages\":\"Article 501815\"},\"PeriodicalIF\":1.2000,\"publicationDate\":\"2025-10-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Actas urologicas espanolas\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S0210480625001330\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"UROLOGY & NEPHROLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Actas urologicas espanolas","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0210480625001330","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"UROLOGY & NEPHROLOGY","Score":null,"Total":0}
Comparación del pronóstico entre carcinoma vesical musculoinvasivo primario y progresivo: análisis prospectivo de resultados a largo plazo tras cistectomía radical
Introduction
Up to 15% of muscle-invasive bladder cancers (MIBC) arise from the progression of a non-muscle-invasive neoplasm. Despite sharing similar treatment strategies, the literature reports differences in survival rates between these 2 groups. This study aims to identify differences in recurrence and survival that may influence individualized treatment approaches.
Material and methods
Prospective study of cystectomies performed for MIBC between 2011 and 2023, collecting demographic, diagnostic, treatment, and recurrence data (local, urothelial, or distant). A comparative and multivariate analysis was conducted.
Results
We did not observe significant differences in recurrence rates between primary and progressive MIBC. However, the group with progression showed better overall survival (OS) rates at 2, 5 and 10 years (100%, 90%, 55%) compared to the primary (80%, 55%, 35%; P = 0.012), as well as better cancer-specific survival (CSS) (100%, 100%, 95% vs. 85%, 77%, 65%; P = 0.033). Independent risk factors for recurrence include pN + (OR: 3.72) and lymphovascular invasion (LVI) (OR: 5.53). Predictors of lower OS include age, nodal involvement, LVI and relapse at any level. For CSS, predictors include nodal involvement, LVI and relapse at any level.
Conclusions
In our series, patients with progressive MIBC have better OS and CSS. For both groups, pN + and LVI are independent risk factors for recurrence. Nodal involvement, LVI and relapse at any level are predictors of poorer OS and CSS.
期刊介绍:
Actas Urológicas Españolas is an international journal dedicated to urological diseases and renal transplant. It has been the official publication of the Spanish Urology Association since 1974 and of the American Urology Confederation since 2008. Its articles cover all aspects related to urology.
Actas Urológicas Españolas, governed by the peer review system (double blinded), is published online in Spanish and English. Consequently, manuscripts may be sent in Spanish or English and bidirectional free cost translation will be provided.