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DC Field | Value | Language |
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dc.contributor.author | Thomas, F | - |
dc.contributor.author | Rosario, DJ | - |
dc.contributor.author | Rubin, N | - |
dc.contributor.author | Goepel, JR | - |
dc.contributor.author | Abbod, MF | - |
dc.contributor.author | Catto, JWF | - |
dc.date.accessioned | 2014-09-02T14:56:05Z | - |
dc.date.available | 2014-09-02T14:56:05Z | - |
dc.date.issued | 2012 | - |
dc.identifier.citation | Cancer, 118(22), 5525 - 5534, 2012 | en_US |
dc.identifier.issn | 0008-543X | - |
dc.identifier.uri | http://onlinelibrary.wiley.com/doi/10.1002/cncr.27587/abstract | en |
dc.identifier.uri | http://bura.brunel.ac.uk/handle/2438/8990 | - |
dc.description | This article is available open access through the publisher’s website from the link below. Copyright © 2012 American Cancer Society. | en_US |
dc.description.abstract | BACKGROUND: The treatment of high-risk nonmuscle-invasive bladder cancer (NMIBC) is difficult given its unpredictable natural history and patient comorbidities. Because current case series are mostly limited in size, the authors report the outcomes from a large, single-center series. METHODS: The authors reviewed all patients with primary, high-risk NMIBC at their institution from 1994 to 2010. Outcomes were matched with clinicopathologic data. Patients who had muscle invasion within 6 months or had insufficient follow-up (<6 months) were excluded. Correlations were analyzed using multivariable Cox regression and log-rank analysis (2-sided; P < .05). RESULTS: In total, 712 patients (median age, 73.7 years) were included. Progression to muscle invasion occurred in 110 patients (15.8%; 95% confidence interval [CI], 13%-18.3%) at a median of 17.2 months (interquartile range, 8.9-35.8 months), including 26.5% (95% CI, 22.2%-31.3%) of the 366 patients who had >5 years follow-up. Progression was associated with age (hazard ratio [HR], 1.04; P = .007), dysplastic urothelium (HR, 1.6; P = .003), urothelial cell carcinoma variants (HR, 3.2; P = .001), and recurrence (HR, 18.3; P < .001). Disease-specific mortality occurred in 134 patients (18.8%; 95% CI, 16.1%-21.9%) at a median of 28 months (interquartile range, 15-45 months), including 28.7% (95% CI, 24.5%-33.3%) of those who had 5 years of follow-up. Disease-specific mortality was associated with age (HR, 1.1; P < .001), stage (HR, 1.7; P = .003), dysplasia (HR, 1.3; P = .05), and progression (HR, 5.2; P < .001). Neither progression nor disease-specific mortality were associated with the receipt of bacillus Calmette-Guerin (P > .6). CONCLUSIONS: Within a program of conservative treatment, progression of high-risk NMIBC was associated with a poor prognosis. Surveillance and bacillus Calmette-Guerin were ineffective in altering the natural history of this disease. The authors concluded that the time has come to rethink the paradigm of management of this disease. | en_US |
dc.description.sponsorship | GlaxoSmithKline, Yorkshire Cancer Research, Sheffield Hospitals Charitable Trust, Astellas Educational Foundation, and the European Union. | en_US |
dc.language | English | - |
dc.language.iso | en | en_US |
dc.publisher | Wiley-Blackwell | en_US |
dc.subject | Bladder | en_US |
dc.subject | Immunotherapy | en_US |
dc.subject | Urothelial cancer | en_US |
dc.subject | Progression | en_US |
dc.subject | Surveillance | en_US |
dc.title | The long-term outcome of treated high-risk nonmuscle-invasive bladder cancer | en_US |
dc.type | Article | en_US |
dc.identifier.doi | http://dx.doi.org/10.1002/cncr.27587 | - |
pubs.organisational-data | /Brunel | - |
pubs.organisational-data | /Brunel/Brunel Staff by College/Department/Division | - |
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pubs.organisational-data | /Brunel/Brunel Staff by College/Department/Division/College of Engineering, Design and Physical Sciences/Dept of Electronic and Computer Engineering | - |
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pubs.organisational-data | /Brunel/University Research Centres and Groups | - |
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pubs.organisational-data | /Brunel/University Research Centres and Groups/Brunel Business School - URCs and Groups/Centre for Research into Entrepreneurship, International Business and Innovation in Emerging Markets | - |
pubs.organisational-data | /Brunel/University Research Centres and Groups/School of Health Sciences and Social Care - URCs and Groups | - |
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pubs.organisational-data | /Brunel/University Research Centres and Groups/School of Health Sciences and Social Care - URCs and Groups/Centre for Systems and Synthetic Biology | - |
Appears in Collections: | Electronic and Electrical Engineering Dept of Electronic and Electrical Engineering Research Papers |
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