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• W2103068818 abstract "No AccessJournal of UrologyAdult urology1 Sep 2007A Randomized Trial of Radical Radiotherapy for the Management of pT1G3 NXM0 Transitional Cell Carcinoma of the Bladder S.J. Harland, H. Kynaston, K. Grigor, D.M. Wallace, C. Beacock, R. Kockelbergh, S. Clawson, T. Barlow, M.K.B. Parmar, G.O. Griffiths, and National Cancer Research Institute Bladder Clinical Studies Group S.J. HarlandS.J. Harland Institute of Urology and Department of Oncology, University College London, London Co-Clinical Coordinators. Financial interest and/or other relationship with Amgen. More articles by this author , H. KynastonH. Kynaston Department of Urology, University Hospital of Wales, Heath Park, Cardiff Co-Clinical Coordinators. More articles by this author , K. GrigorK. Grigor Department of Pathology, Western General Hospital, Edinburgh More articles by this author , D.M. WallaceD.M. Wallace Department of Urology, Queen Elizabeth Hospital, Birmingham More articles by this author , C. BeacockC. Beacock Department of Urology, Royal Shrewsbury Hospital, Shrewsbury More articles by this author , R. KockelberghR. Kockelbergh Department of Urology, Leicester General Hospital, Leicester More articles by this author , S. ClawsonS. Clawson Cancer Group, Medical Research Council Clinical Trials Unit, London More articles by this author , T. BarlowT. Barlow Cancer Group, Medical Research Council Clinical Trials Unit, London More articles by this author , M.K.B. ParmarM.K.B. Parmar Cancer Group, Medical Research Council Clinical Trials Unit, London More articles by this author , G.O. GriffithsG.O. Griffiths Cancer Group, Medical Research Council Clinical Trials Unit, London More articles by this author , and National Cancer Research Institute Bladder Clinical Studies Group More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2007.05.024AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: We conducted a multicenter randomized trial in the United Kingdom to determine the efficacy of radical radiotherapy in reducing the incidence of progression of pT1G3 transitional cell carcinoma of the bladder to muscle invasive disease and subsequent disease fatality. Materials and Methods: Patients with a new diagnosis of pT1G3 NXM0 transitional cell carcinoma with unifocal disease and no carcinoma in situ (group 1), or with multifocal disease and/or carcinoma in situ (group 2) were eligible for the trial. Patients in group 1 were randomized between observation and radiotherapy to the bladder, and in group 2 between intravesical therapy and radiotherapy. Results: From September 1991 to February 2003 a total of 210 patients from 37 centers in the United Kingdom were entered into the study. There were 77 patients in group 1 and 133 patients in group 2, and 6 patients were excluded from analysis because they were found to have pT2 disease by the reference pathologist. No evidence of an advantage with radiotherapy was found in terms of progression-free interval (hazard ratio 1.07; 95% CI 0.65, 1.74; p = 0.785), progression-free survival (hazard ratio 1.35; 95% CI 0.92, 1.98; p = 0.133) or overall survival (hazard ratio 1.32; 95% CI 0.86, 2.04; p = 0.193). Conclusions: To our knowledge this is the largest randomized trial performed in patients with pT1G3 disease for which 210 patients were recruited during 11 years. There is no evidence that radiotherapy is better than more conservative treatment. The prognosis of this group of patients appears to be poor irrespective of treatment and new treatment strategies need to be investigated. References 1 www.cancerresearchuk.org/statistics. Accessed March 2007. Google Scholar 2 : A second look at the pT1 G3 bladder tumour. Clin Oncol (R Coll Radiol)2005; 17: 498. Google Scholar 3 : Transitional carcinoma of the bladder: back to basics. Urology News1997; 1: 11. Google Scholar 4 : Intravesical bacillus Calmette-Guerin versus mitomycin C for superficial bladder cancer: a formal meta-analysis of comparative studies on recurrence and toxicity. J Urol2003; 169: 90. Link, Google Scholar 5 : Intravesical bacillus Calmette-Guerin reduces the risk of progression in patients with superficial bladder cancer: a meta-analysis of the published results of randomized clinical trials. J Urol2002; 168: 1964. Link, Google Scholar 6 : The fate of G3pT1 bladder cancer. Br J Urol1989; 64: 608. Google Scholar 7 : Treatment of superficial (T1) tumours of the bladder by radical radiotherapy. Br J Urol1986; 58: 147. Google Scholar 8 : Urologists’ attitudes to the management of bladder cancer. Br J Urol1992; 70: 522. Google Scholar 9 : Prognostic factors in local surgical treatment of invasive bladder cancer, with special reference to the presence of urothelial dysplasia. Cancer1983; 51: 1710. Google Scholar 10 : Stage T1, grade 3 transitional cell carcinoma of the bladder: an unfavorable tumor?. J Urol1987; 137: 39. Link, Google Scholar 11 : The role of repeat transurethral resection in the management of high-risk superficial transitional cell bladder cancer. BJU Int2005; 96: 759. Google Scholar 12 : A retrospective analysis of 153 patients treated with or without intravesical bacillus Calmette-Guerin for primary stage T1 grade 3 bladder cancer: recurrence, progression and survival. J Urol2003; 169: 96. Link, Google Scholar 13 : A prospective randomized trial of maintenance versus nonmaintenance intravesical bacillus Calmette-Guerin therapy of superficial bladder cancer. J Clin Oncol1987; 5: 441. Crossref, Medline, Google Scholar 14 : Maintenance bacillus Calmette-Guerin immunotherapy for recurrent Ta, T1 and carcinoma in situ transitional cell carcinoma of the bladder: a randomized Southwest Oncology Group Study. J Urol2000; 163: 1124. Link, Google Scholar 15 : Control group and maintenance treatment with bacillus Calmette-Guerin for carcinoma in situ and/or high grade bladder tumors. J Urol2001; 165: 1488. Link, Google Scholar © 2007 by American Urological AssociationFiguresReferencesRelatedDetails Volume 178Issue 3September 2007Page: 807-813 Advertisement Copyright & Permissions© 2007 by American Urological AssociationKeywordsradiotherapyrandomized controlled trialsurinary bladder neoplasmsMetricsAuthor Information S.J. Harland Institute of Urology and Department of Oncology, University College London, London Co-Clinical Coordinators. Financial interest and/or other relationship with Amgen. More articles by this author H. Kynaston Department of Urology, University Hospital of Wales, Heath Park, Cardiff Co-Clinical Coordinators. More articles by this author K. Grigor Department of Pathology, Western General Hospital, Edinburgh More articles by this author D.M. Wallace Department of Urology, Queen Elizabeth Hospital, Birmingham More articles by this author C. Beacock Department of Urology, Royal Shrewsbury Hospital, Shrewsbury More articles by this author R. Kockelbergh Department of Urology, Leicester General Hospital, Leicester More articles by this author S. Clawson Cancer Group, Medical Research Council Clinical Trials Unit, London More articles by this author T. Barlow Cancer Group, Medical Research Council Clinical Trials Unit, London More articles by this author M.K.B. Parmar Cancer Group, Medical Research Council Clinical Trials Unit, London More articles by this author G.O. Griffiths Cancer Group, Medical Research Council Clinical Trials Unit, London More articles by this author National Cancer Research Institute Bladder Clinical Studies Group More articles by this author Expand All Advertisement PDF downloadLoading ..." @default.
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