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Time to progression is the main predictor of survival in patients with high-risk nonmuscle invasive bladder cancer: Results from a machine learning-based analysis of a large multi-institutional database.
Porreca, Annamaria; Di Nicola, Marta; Lucarelli, Giuseppe; Dorin, Vartolomei Mihai; Soria, Francesco; Terracciano, Daniela; Mistretta, Francesco Alessandro; Luzzago, Stefano; Buonerba, Carlo; Cantiello, Francesco; Mari, Andrea; Minervini, Andrea; Veccia, Alessandro; Antonelli, Alessandro; Musi, Gennaro; Hurle, Rodolfo; Busetto, Gian Maria; Del Giudice, Francesco; Ferretti, Simone; Perdonà, Sisto; Prete, Paola Del; Porreca, Angelo; Bove, Pierluigi; Crisan, Nicolae; Russo, Giorgio Ivan; Damiano, Rocco; Amparore, Daniele; Porpiglia, Francesco; Autorino, Riccardo; Piccinelli, Mattia; Brescia, Antonio; Tataru, Sabin Octavian; Crocetto, Felice; Giudice, Arturo Lo; de Cobelli, Ottavio; Schips, Luigi; Ferro, Matteo; Marchioni, Michele.
Afiliación
  • Porreca A; Biostatistics Laboratory, Department of Medical, Oral and Biotechnological Sciences, "G. d'Annunzio" University of Chieti, Chieti, Italy.
  • Di Nicola M; Biostatistics Laboratory, Department of Medical, Oral and Biotechnological Sciences, "G. d'Annunzio" University of Chieti, Chieti, Italy.
  • Lucarelli G; Urology, Andrology and Kidney Transplantation Unit, Department of Emergency and Organ Transplantation, University of Bari, Bari, Italy.
  • Dorin VM; Department of Cell and Molecular Biology, George Emil Palade University of Medicine, Pharmacy, Sciences and Technology from Târgu Mureș, Târgu Mureș, Romania.
  • Soria F; Division of Urology, Department of Surgical Sciences, Torino School of Medicine, Torino, Italy.
  • Terracciano D; Department of Translational Medical Sciences, University Federico II, Napoli, Italy.
  • Mistretta FA; Department of Urology, IEO European Institute of Oncology, IRCCS, Milan, Italy.
  • Luzzago S; Department of Urology, IEO European Institute of Oncology, IRCCS, Milan, Italy.
  • Buonerba C; CRTR Rare Tumors Reference Center, AOU Federico II, Napoli, Italy.
  • Cantiello F; Department of Urology, Magna Graecia University of Catanzaro, Catanzaro, Italy.
  • Mari A; Unit of Oncologic Minimally-Invasive Urology and Andrology, Department of Urology, Careggi Hospital, University of Florence, Florence, Italy.
  • Minervini A; Unit of Oncologic Minimally-Invasive Urology and Andrology, Department of Urology, Careggi Hospital, University of Florence, Florence, Italy.
  • Veccia A; Department of Urology, University of Verona, Verona, Italy.
  • Antonelli A; Department of Urology, University of Verona, Verona, Italy.
  • Musi G; Department of Urology, IEO European Institute of Oncology, IRCCS, Milan, Italy.
  • Hurle R; Department of Urology, Humanitas Clinical and Research Hospital, Rozzano, Milan, Italy.
  • Busetto GM; Department of Urology, University of Foggia, Foggia, Italy.
  • Del Giudice F; Department of Urology, La Sapienza University of Rome, Rome, Italy.
  • Ferretti S; Urology Unit, Department of Medical, Oral and Biotechnological Sciences, "SS. Annunziata" Hospital, "G. d'Annunzio" University of Chieti, Chieti, Italy.
  • Perdonà S; Uro-Gynecological Department, Istituto Nazionale per lo Studio e la Cura dei Tumori, Fondazione "G. Pascale"-IRCCS, Naples, Italy.
  • Prete PD; Scientific Directorate, Istituto Nazionale per lo Studio e la Cura dei Tumori, Fondazione "G. Pascale"-IRCCS, Naples, Italy.
  • Porreca A; Department of Robotic Urologic Surgery, Abano Terme Hospital, Abano Terme, Italy.
  • Bove P; Division of Urology, Department of Experimental Medicine and Surgery, Tor Vergata University of Rome, Rome, Italy.
  • Crisan N; Department of Urology, University of Medicine and Pharmacy Iuliu Hatieganu, Cluj-Napoca, Romania.
  • Russo GI; Department of Urology, University of Catania, Catania, Italy.
  • Damiano R; Department of Urology, Magna Graecia University of Catanzaro, Catanzaro, Italy.
  • Amparore D; Division of Urology, Department of Oncology, School of Medicine, San Luigi Hospital, University of Turin, Orbassano, Turin, Italy.
  • Porpiglia F; Division of Urology, Department of Oncology, School of Medicine, San Luigi Hospital, University of Turin, Orbassano, Turin, Italy.
  • Autorino R; Department of Urology, Rush University Medical Center, Chicago, IL.
  • Piccinelli M; Department of Urology, IEO European Institute of Oncology, IRCCS, Milan, Italy.
  • Brescia A; Department of Urology, IEO European Institute of Oncology, IRCCS, Milan, Italy.
  • Tataru SO; I.O.S.U.D., George Emil Palade University of Medicine, Pharmacy, Sciences and Technology from Târgu Mureș, Târgu Mureș, Romania.
  • Crocetto F; Department of Neurosciences, Science of Reproduction and Odontostomatology, University of Naples Federico II, 80131 Naples, Italy.
  • Giudice AL; Department of Urology, University of Catania, Catania, Italy.
  • de Cobelli O; Department of Urology, IEO European Institute of Oncology, IRCCS, Milan, Italy.
  • Schips L; Urology Unit, Department of Medical, Oral and Biotechnological Sciences, "SS. Annunziata" Hospital, "G. d'Annunzio" University of Chieti, Chieti, Italy.
  • Ferro M; Department of Urology, IEO European Institute of Oncology, IRCCS, Milan, Italy.
  • Marchioni M; Urology Unit, Department of Medical, Oral and Biotechnological Sciences, "SS. Annunziata" Hospital, "G. d'Annunzio" University of Chieti, Chieti, Italy. Electronic address: mic.marchioni@gmail.com.
Urol Oncol ; 42(3): 69.e17-69.e25, 2024 03.
Article en En | MEDLINE | ID: mdl-38302296
ABSTRACT

BACKGROUND:

In patients affected by high-risk nonmuscle invasive bladder cancer (HR-NMIBC) progression to muscle invasive status is considered as the main indicator of local treatment failure. We aimed to investigate the effect of progression and time to progression on overall survival (OS) and to investigate their validity as surrogate endpoints.

METHODS:

A total of 1,510 patients from 18 different institutions treated for T1 high grade NMIBC, followed by a secondary transurethral resection and BCG intravesical instillation. We relied on random survival forest (RSF) to rank covariates based on OS prediction. Cox's regression models were used to quantify the effect of covariates on mortality.

RESULTS:

During a median follow-up of 49.0 months, 485 (32.1%) patients progressed to MIBC, while 163 (10.8%) patients died. The median time to progression was 82 (95%CI 78.0-93.0) months. In RSF time-to-progression and age were the most predictive covariates of OS. The survival tree defined 5 groups of risk. In multivariable Cox's regression models accounting for progression status as time-dependent covariate, shorter time to progression (as continuous covariate) was associated with longer OS (HR 9.0, 95%CI 3.0-6.7; P < 0.001). Virtually same results after time to progression stratification (time to progression ≥10.5 months as reference).

CONCLUSION:

Time to progression is the main predictor of OS in patients with high risk NMIBC treated with BCG and might be considered a coprimary endpoint. In addition, models including time to progression could be considered for patients' stratification in clinical practice and at the time of clinical trials design.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Neoplasias de la Vejiga Urinaria / Neoplasias Vesicales sin Invasión Muscular Tipo de estudio: Etiology_studies / Prognostic_studies / Risk_factors_studies Límite: Humans Idioma: En Revista: Urol Oncol Asunto de la revista: NEOPLASIAS / UROLOGIA Año: 2024 Tipo del documento: Article País de afiliación: Italia Pais de publicación: Estados Unidos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Neoplasias de la Vejiga Urinaria / Neoplasias Vesicales sin Invasión Muscular Tipo de estudio: Etiology_studies / Prognostic_studies / Risk_factors_studies Límite: Humans Idioma: En Revista: Urol Oncol Asunto de la revista: NEOPLASIAS / UROLOGIA Año: 2024 Tipo del documento: Article País de afiliación: Italia Pais de publicación: Estados Unidos