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

according to a study conducted by the Fundació Puigvert

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

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

Barcelona, January of 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 T1G3 bladder cancer, treated conservatively with Bacil of Calmette Guerin (BCG) intravesical. This is the main conclusion to be drawn from a study carried out in the Fundació Puigvert 146 patients with bladder cancer 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 them not her invading, known as non-muscle-invasive. In Spain, about 10,000 cases are diagnosed a 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 that prevents extracting the urinary bladder. They are frequently 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 given time and acting on the malignant cells of the bladder.

According to Dr. Palou, head of the unit of oncological Urology 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 aims to the importance of this issue lies in the fact that, when a tumor under these circumstances becomes infiltrating, often increases the likelihood of dying 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 in the Foundation, clinical factors that allow in the most appropriate way to decide what to do in cases of bladder cancer category T1G3 is available. The study demonstrated that in case of a woman, or if it detects a carcinoma in situ in the prostatic urethra, it is better to perform a radical cystectomy as immediate treatment rather than pursuing a conservative BCG treatment, because the risk of progression is highest.

By what referring to the difference in Outlook between man and women, when we talk about bladder cancer, should emphasize that a woman usually implies a worse prognosis. Anyway, the reasons why female presents a more negative Outlook 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 try with conservative treatment of BCG.

On the Fundació Puigvert