INTRODUCTION: In non-muscle invasive tumors (TNMI), muscle-invasive (MI) stage progression occurs in one third of cases. Prognostic factors have been described.
We analyze the prognostic factors in our series and their efficacy in prophylactic treatment.
MATERIAL AND METHOD: 1287 TNMI TaG2-T1G3 with a minimum follow-up of five years. Prophylactic treatment has been carried out 49% (20% MMC, 29% BCG).
By means of a multivariate study, those that have independent prognostic value are selected and the repercussion of the progressive sum of them on the response to prophylactic treatment with MMC or BCG and its influence on the progression to MI is evaluated.
RESULTS: With a TLE of 51.2 months, 9.6% of the series have progressed.
Independent prognostic factors: stage T1, high grade G3, lymphovascular permeationL1.
They have progressed 11.3% of the T1, 19.4% of the G3 and 28.3% of the L1
The risks of progression of its sum are:
|
|
N
|
PROGRESSION
|
|
Any
|
309
|
12 (3,9%)
|
|
One
|
636
|
45 (7,1%)
|
|
Two
|
310
|
55 (17,1%)
|
|
Three
|
32
|
12 (37,4%)
|
Seeing the repercussion of the prophylactic:
|
(%)
|
PROGRESSION
|
|
|
No treatment
|
MMC
|
p
|
BCG
|
p
|
|
Any
|
5
|
0
|
.073
|
9,1
|
NS
|
|
One
|
7,6
|
6
|
NS
|
7,3
|
NS
|
|
Two
|
24,5
|
22,7
|
NS
|
12,6
|
.014
|
|
Three
|
35,7
|
-
|
NS
|
41,2
|
NS
|
CONCLUSIONS:
T1G3L1 tumors have more than a third chance of progressing to muscle-inflitting stage without the prophylactic treatment with BCG decreasing it
Tumors with two risk factors benefit from BCG treatment.
MMC does not decrease progression in any group.
