Risk factors for recurrence of non-muscle invasive bladder cancer after transurethral resection of bladder tumour combined with Bacillus Calmette-Guérin perfusion
Ke Chunjin, Long Gongwei, Liu Zhenghao, Ruan Weiqiang, Li Le, Tian Jihua, Gan Jiaye, Zeng Xin, Hu Zhiquan*, Yang Chunguang
Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
Abstract：Objective： To explore the risk factors for recurrence of non-muscular invasive bladder cancer （NMIBC） after transurethral resection of bladder tumour （TURBT） combined with Bacillus Calmette-Guérin （BCG） perfusion. Methods： Patients with intravesical BCG perfusion in our hospital in recent 5 years were selected as subjects. Clinical data including basic demographic characteristics of patients, fluorescence in situ hybridization （FISH） test results after BCG perfusion, TNM stage, tumor histological grade, multiple tumors, history of bladder cancer, recurrence and progression after BCG perfusion were collected. The characteristics of queue data were generalized and summarized. Cox proportional risk regression analyses were used to identify risk factors for recurrence or progression. Results： A total of 69 patients were enrolled, including 58 （84.06%） males and 11 （15.94%） females, with a median age of 64 （55.25-70.00） years. According to the recurrence or not after BCG perfusion, the patients were divided into recurrence group （n=10） and non-recurrence group （n=59）. After BCG perfusion, all patients withpositive FISH recurred, while none of the patients with negative FISH recurred. There were no significant differences in gender, age, non-BCG perfusion history in bladder and BCG adverse perfusion reactions between the non-recurrent group and the recurrent group （P>0.05）, but patients with later TNM stage, poor tissue differentiation, bladder cancer history, multiple tumors, and positive FISH after BCG perfusion were more likely to relapse （P<0.05）. Univariate Cox proportional risk regression analysis showed that positive FISH after BCG perfusion, TNM stage, and multiple tumor were closely correlated with tumor recurrence and progression （P<0.05）, but there was no correlation between histological grade and disease progression （P=0.064）. The histological grade was correlated with disease recurrence （P=0.038）. Multivariate Cox proportional hazard regression confirmed that positive FISH after BCG perfusion was an independent risk factor for recurrence [HR： 12.746, 95% CI： 3.828-79.541, P=0.002]. Conclusions： Positive FISH after BCG perfusion, TNM clinical stage and multiple tumors were risk factors for recurrence and progression of bladder cancer. After BCG perfusion, the follow-up interval of patients with negative FISH can be appropriately extended, while patients with positive FISH should be followed closely and the follow-up interval should be appropriately shortened.
柯春锦, 龙恭伟, 刘正浩, 阮伟强, 李乐, 田继华, 甘家骅, 曾星, 胡志全, 杨春光. 非肌层浸润性膀胱癌行经尿道膀胱肿瘤切除术联合卡介苗灌注后复发危险因素分析[J]. 微创泌尿外科杂志, 2022, 11(4): 252-257.
Ke Chunjin, Long Gongwei, Liu Zhenghao, Ruan Weiqiang, Li Le, Tian Jihua, Gan Jiaye, Zeng Xin, Hu Zhiquan, Yang Chunguang. Risk factors for recurrence of non-muscle invasive bladder cancer after transurethral resection of bladder tumour combined with Bacillus Calmette-Guérin perfusion. JOURNAL OF MINIMALLY INVASIVE UROLOGY, 2022, 11(4): 252-257.
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