Risk Stratification Examined for High-Grade Ta Bladder Tumors
For patients treated with adequate BCG, risk for BCG unresponsiveness, progression similar for all high-grade Ta tumors
TUESDAY, Aug. 2, 2022 (HealthDay News) -- For patients treated with adequate bacillus Calmette-Guérin (BCG), all high-grade (HG) Ta tumors have similar rates of BCG unresponsiveness and progression, regardless of prognostic risk factors, according to a study published in the August issue of The Journal of Urology.
Kelly K. Bree, M.D., from the University of Texas MD Anderson Cancer Center in Houston, and colleagues conducted an institutional review of all patients with Ta tumors who received adequate BCG from 2000 to 2018. Patients were stratified by the newly proposed adverse risk factors into European Association of Urology (EAU) 2021 prognostic risk groups.
The researchers found that 16, 40, and 44 percent of patients had intermediate-risk (IR) low-grade (LG) Ta, IR high-grade (HG) Ta, and high-risk (HR) HG Ta tumors, respectively. BCG unresponsiveness developed in 13 and 14 percent of HR HG Ta and IR HG Ta tumors, respectively, compared with 0.0 percent of IR LG tumors. None of the patients with IR LG Ta tumors progressed, while similar progression rates were seen for HR HG Ta and IR HG Ta tumors (≥T2: 5.9 and 6.5 percent; ≥T1: 13 and 13 percent, respectively). Similar rates of recurrence, BCG unresponsiveness, and progression were seen, regardless of the number of EAU risk factors present.
"Current clinical risk factors do not adequately improve risk stratification among patients with HG Ta tumors receiving adequate BCG," the authors write. "These data support the former EAU risk stratification model and suggest that all HG Ta lesions should be considered high risk."
Two authors disclosed financial ties to the biopharmaceutical industry.