Be women or have a urothelial carcinoma in the prostatic urethra are factors of recurrence and progression in T1G3 bladder cancer

according to a study by the Fundació Puigvert

– in these cases, the Fundació Puigvert experts advise removing the bladder instead of applying a conservative treatment with Bacil of Calmette Guerin (BCG) intravesical.

– the study has been made between 146 patients with cancer bladder muscle-noninvasive and has made it possible to reconsider the therapeutic attitude in T1G3 tumors to increase the life expectancy of patients.

Barcelona, January 2012.- Having a carcinoma in situ in the prostatic urethra or being a woman are factors that predict recurrence and progression and death in patients with bladder T1G3 cancer, treated conservatively with Bacil of Calmette Guerin (BCG) intravesical. This is the main conclusion to be drawn from a study carried out at the Fundació Puigvert with 146 patients with bladder cancer non muscle-invasive of high-risk T1G3.

In cases of bladder cancer, differentiated two types of malignant tumors: those who invade the muscle layer, called muscle-invasive, and which not her invade, known as non-muscle-invasive. In Spain are diagnosed about 10,000 cases per year of tumor of bladder, of whom 70% are non-muscle-invasive.

Tumors not muscle-invasive, to not have invaded the muscle layer, have a better prognosis and are candidates for a conservative treatment to avoid removing the urinary bladder. They are very often treated with immunotherapy by Bacil of Calmette Guerin (BCG). This treatment is applied directly into the bladder, several times, through a catheter, injecting the BCG solution during a specified time and acting on the malignant cells of the bladder.

According to Dr. Palou, head of the unit of Urology Oncology of the Fundació Puigvert and head of the study, factors of prognosis of patients with high-risk bladder cancer treated with BCG muscle-invasive not are unclear or are not sufficiently discriminatory. Some tumors have recurrence and others evolve into a tumor infiltrated the muscular layer ”. And points out that the importance of this issue lies in the fact that, when a tumor in these circumstances it becomes infiltrating, often increases the probability of death due to the tumor ”.

So far, experts have been based on Predictive factors of response to treatment but as explains Palou, these are fairly generic and little discriminatory, so it is difficult to know in advance whether the patient will develop more aggressive tumors ”. Thanks to the study on the Foundation, it has clinical factors that decide how best to do in cases of bladder cancer category T1G3. The study demonstrated that in case of a woman or if it detects a carcinoma in situ in the prostatic urethra, it is best to perform a radical cystectomy as immediate treatment rather than pursuing a conservative BCG treatment, because the risk of progression is highest.

For what it refers to the outcome difference between men and women, when we talk about bladder cancer, we must emphasize that a woman usually implies a worse prognosis. Anyway, the reasons why female presents a negative prognosis are still unclear and remain cause for study.

It is all this that the Fundació Puigvert experts advise that, in case of a woman or if it detects a carcinoma in situ in the prostatic urethra, a removal of the bladder is made initially and not test with conservative treatment of BCG.

On the Fundació Puigvert