|
|
|
| Prediction of recurrence risk in patients with non-muscle-invasive bladder cancer |
Niloufar Ahmadia,Hamid Shafeea,Emaduddin Moudib,*( )
|
aDepartment of Urology, School of Medicine, Babol University of Medical Sciences, Babol, Iran
bDepartment of Surgery, Cancer Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran |
|
|
|
|
Abstract Objective: Non-muscle-invasive bladder cancer (NMIBC) remains a common challenge in uro-oncology with conflicting reports on recurrence risk. This study aimed to elucidate the recurrence rate of NMIBC in the Cancer Clinic of Shahid Beheshti Hospital in Iran and to investigate related parameters affecting recurrence risk. Methods: The data of 143 patients with NMIBC, who underwent treatment between January 2017 and January 2020 and were followed up from the initial transurethral resection of bladder tumor until November 30, 2020 in our institution, were retrospectively assessed. The Cox regression analysis and Kaplan-Meier plot of recurrence-free survival were used to determine independent contributing factors for tumor recurrence. Results: Among patients with NMIBC, 83.9% were male, and 16.1% were female, with a mean age of 64.4 (standard deviation [SD] 12.9) years. During the follow-up, 71 (49.7%) patients showed tumor recurrence, with a mean recurrence time of 11.5 (SD 6.9) months. In the Chi-square test or Fisher's exact test, the age (≥65 years) (p=0.037), obesity (body mass index ≥30 kg/m2) (p=0.004), no diabetes mellitus (p=0.005), smoking (current or former smoker) (p=0.001), immediate perfusion therapy (p=0.035), number of tumors (>3) (p<0.001), and tumor stage (Ta, T1, and Tis) (p=0.001) had independent significant effects on the recurrence of NMIBC. The multivariate Cox regression analysis indicated that preoperative obesity (hazards ratio [HR] 7.90; 95% confidential interval [CI] 4.01-15.55; p<0.001), current or former smoking (HR 1.85; 95% CI 1.07-3.20; p=0.027), and a high-grade tumor (HR 4.03; 95% CI 1.59-10.25; p=0.003) were significant predictors of tumor recurrence. The Kaplan-Meier plot of recurrence-free survival showed that obesity (log-rank p<0.001), current or former smoking (log-rank p=0.001), and a high-grade tumor (log-rank p=0.006) were associated with a shorter time interval until the first tumor recurrence. Conclusion: The study found a high recurrence rate of NMIBC in Iran from January 2017 to January 2020, with the obesity, smoking history, and the high-grade tumor as contributing factors.
|
|
Received: 30 January 2023
Available online: 20 October 2024
|
|
Corresponding Authors:
*E-mail address: emoudi@mubabol.ac.ir (E. Moudi).
|
|
|
| Characteristic | Patient (n=143) | Non-recurrence tumor (n=72) | Recurrence tumor (n=71) | p-Valuea | | Age, year | | | | | | <65 | 75 (52.4) | 44 (61.1) | 31 (43.7) | NR | | ≥65 | 68 (47.6) | 28 (38.9) | 40 (56.3) | 0.037 | | Gender | | | | 0.849 | | Female | 23 (16.1) | 12 (16.7) | 11 (15.5) | | | Male | 120 (83.9) | 60 (83.3) | 60 (84.5) | | | BMI, kg/m2 | | | | | | <30 | 106 (74.1) | 61 (84.7) | 45 (63.4) | NR | | ≥30 | 37 (25.9) | 11 (15.3) | 26 (36.6) | 0.004 | | Diabetes mellitus | | | | | | Yes | 121 (84.6) | 67 (93.1) | 54 (76.1) | NR | | No | 22 (15.4) | 5 (6.9) | 17 (23.9) | 0.005 | | Smoking history | | | | | | Current or former smoker | 66 (46.2) | 23 (31.9) | 43 (60.6) | 0.001 | | Never smoker | 77 (53.8) | 49 (68.1) | 28 (39.4) | NR | | Tumor size, cm | | | | 0.001 | | <3 | 63 (44.1) | 42 (58.3) | 21 (29.6) | | | ≥3 | 80 (55.9) | 30 (41.7) | 50 (70.4) | | | Number of tumor | | | | | | 1-3 | 55 (38.5) | 41 (56.9) | 14 (19.7) | NR | | >3 | 88 (61.5) | 31 (43.1) | 57 (80.3) | <0.001 | | Tumor grade | | | | 0.060 | | Low | 27 (18.9) | 18 (25.0) | 9 (12.7) | | | High | 116 (81.1) | 54 (75.0) | 62 (87.3) | | | Tumor stage | | | | 0.001 | | Ta | 85 (59.4) | 52 (72.2) | 33 (46.5) | | | T1 | 28 (19.6) | 6 (8.3) | 22 (31.0) | | | Tis (CIS) | 30 (21.0) | 14 (19.4) | 16 (22.5) | | | Immediate infusion therapy | | | | | | Yes | 78 (54.5) | 33 (45.8) | 45 (63.4) | 0.035 | | No | 65 (45.5) | 39 (54.2) | 26 (36.6) | NR |
|
|
Descriptive statistics of patients with non-muscle invasive bladder cancer between January 2017 and January 2020 at a tertiary referral center.
|
| Variable | Univariate analysis | Multivariate analysis | | HR (95% CI) | p-Value | HR (95% CI) | p-Value | | Age, year | | <65 | 1.00 | Ref | NA | NA | | ≥65 | 0.92 (0.58-1.48) | 0.743 | NA | NA | | BMI, kg/m2 | | <30 | 1.00 | Ref | 1.00 | Ref | | ≥30 | 4.31 (2.47-7.53) | <0.001 | 7.90 (4.01-15.55) | <0.001 | | Diabetes mellitus | | Yes | 1.03 (0.58-1.82) | 0.917 | NA | NA | | No | 1.00 | Ref | NA | NA | | Smoking history | | Current or former smoker | 2.30 (1.35-3.90) | 0.002 | 1.85 (1.07-3.20) | 0.027 | | Never smoker | 1.00 | Ref | 1.00 | Ref | | Alcohol intake | | Yes | 1.38 (0.751-2.54) | 0.299 | NA | NA | | No | 1.00 | Ref | NA | NA | | Tumor size, cm | | <3 | 1.00 | Ref | NA | NA | | ≥3 | 1.32 (0.773-2.25) | 0.310 | NA | NA | | Number of tumor | | 1-3 | 1.00 | Ref | NA | NA | | >3 | 1.22 (0.68-2.21) | 0.506 | NA | NA | | Tumor grade | | Low | 1.00 | Ref | 1.00 | Ref | | High | 2.58 (1.21-5.53) | 0.014 | 4.03 (1.59-10.25) | 0.003 | | Tumor stage | | Ta | 1.00 | Ref | NA | NA | | T1 | 1.41 (0.81-2.45) | 0.222 | NA | NA | | Tis (CIS) | 1.62 (0.87-3.01) | 1.30 | NA | NA | | Immediate infusion therapy | | Yes | 0.90 (0.55-1.48) | 0.688 | NA | NA | | No | 1.00 | Ref | NA | NA |
|
|
The Cox regression analyses predicting for the risk of recurrence in patients with non-muscle-invasive bladder cancer between January 2017 and January 2020 at a tertiary referral center.
|
|
|
The Kaplan-Meier plot of recurrence-free survival of patients with non-muscle-invasive bladder cancer with obesity (log-rank p<0.001). BMI, body mass index.
|
|
|
The Kaplan-Meier plot of recurrence-free survival of patients with non-muscle-invasive bladder cancer with and without history of cigarette smoking (log-rank p=0.001).
|
|
|
The Kaplan-Meier plot of recurrence-free survival of patients with non-muscle-invasive bladder cancer with high-grade tumor and low-grade tumor (log-rank p=0.006).
|
| [1] |
Woldu SL, Bagrodia A, Lotan Y. Guideline of guidelines: nonmuscle- invasive bladder cancer. BJU Int 2017; 119:371-80.
|
| [2] |
Sung H, Ferlay J, Siegel RL, Laversanne M, Soerjomataram I, Jemal A, et al. Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin 2021; 71:209-49.
|
| [3] |
Heney NM. Natural history of superficial bladder cancer. Prognostic features and long-term disease course. Urol Clin North Am 1992; 19:429-33.
|
| [4] |
Herr HW. The value of a second transurethral resection in evaluating patients with bladder tumors. J Urol 1999; 162:74-6.
doi: 10.1097/00005392-199907000-00018
pmid: 10379743
|
| [5] |
Sfakianos JP, Kim PH, Hakimi AA, Herr HW. The effect of restaging transurethral resection on recurrence and progression rates in patients with nonmuscle invasive bladder cancer treated with intravesical bacillus CalmetteeGuérin. J Urol 2014; 191:341-5.
doi: 10.1016/j.juro.2013.08.022
pmid: 23973518
|
| [6] |
Babjuk M, Burger M, Compérat EM, Gontero P, Mostafid AH, Palou J, et al. European Association of Urology guidelines on non-muscle-invasive bladder cancer (TaT1 and carcinoma in situ)d2019 update. Eur Urol 2019; 76:639-57.
|
| [7] |
Chou R, Gore JL, Buckley D, Fu R, Gustafson K, Griffin JC, et al. Urinary biomarkers for diagnosis of bladder cancer: a systematic review and meta-analysis. Ann Intern Med 2015; 163:922-31.
doi: 10.7326/M15-0997
pmid: 26501851
|
| [8] |
Sylvester RJ, van der Meijden AP, Oosterlinck W, Witjes JA, Bouffioux C, Denis L, et al. Predicting recurrence and progression in individual patients with stage Ta T1 bladder cancer using EORTC risk tables: a combined analysis of 2596 patients from seven EORTC trials. Eur Urol 2006; 49:466-7.
doi: 10.1016/j.eururo.2005.12.031
pmid: 16442208
|
| [9] |
Matulewicz RS, Steinberg GD. Non-muscle-invasive bladder cancer: overview and contemporary treatment landscape of neoadjuvant chemoablative therapies. Rev Urol 2020; 22:43-51.
pmid: 32760227
|
| [10] |
Rosevear HM, Lightfoot AJ, Nepple KG, O’Donnell MA. Usefulness of the Spanish Urological Club for Oncological Treatment scoring model to predict nonmuscle invasive bladder cancer recurrence in patients treated with intravesical bacillus CalmetteeGuérin plus interferon-a. J Urol 2011; 185:67-71.
doi: 10.1016/j.juro.2010.08.083
pmid: 21074202
|
| [11] |
Ferro M, Marchioni M, Lucarelli G, Vartolomei MD, Soria F, Terracciano D, et al. Association of statin use and oncological outcomes in patients with first diagnosis of T1 high grade nonmuscle invasive urothelial bladder cancer: results from a multicenter study. Minerva Urol Nephrol 2021; 73:796-802.
|
| [12] |
Zuniga KB, Graff RE, Feiger DB, Meng MV, Porten SP, Kenfield SA. Lifestyle and non-muscle invasive bladder cancer recurrence, progression, and mortality: available research and future directions. Bladder Cancer 2020; 6:9-23.
|
| [13] |
Madeb R, Messing EM. Gender, racial and age differences in bladder cancer incidence and mortality. Urol Oncol 2004; 22:86-92.
|
| [14] |
Underwood 3rd W, Dunn RL, Williams C, Lee CT. Gender and geographic influence on the racial disparity in bladder cancer mortality in the US. J Am Coll Surg 2006; 202:284-90.
|
| [15] |
Ucpinar B, Erbin A, Ayranci A, Caglar U, Alis D, Basal S, et al. Prediction of recurrence in non-muscle invasive bladder cancer patients. Do patient characteristics matter? BUON 2019; 24:1659-65.
|
| [16] |
Li HM, Azhati B, Rexiati M, Wang WG, Li XD, Liu Q, et al. Impact of smoking status and cumulative smoking exposure on tumor recurrence of non-muscle-invasive bladder cancer. Int Urol Nephrol 2017; 49:69-76.
doi: 10.1007/s11255-016-1441-6
pmid: 27766490
|
| [17] |
Kluth LA, Xylinas E, Crivelli JJ, Passoni N, Comploj E, Pycha A, et al. Obesity is associated with worse outcomes in patients with T1 high grade urothelial carcinoma of the bladder. J Urol 2013; 190:480-6.
doi: 10.1016/j.juro.2013.01.089
pmid: 23376707
|
| [18] |
Gunlusoy B, Ceylan Y, Degirmenci T, Kozacioglu Z, Yonguc T, Bozkurt H, et al. Urothelial bladder cancer in young adults: diagnosis, treatment and clinical behaviour. Can Urol Assoc J 2015; 9:E727-30. https://doi.org/10.5489/cuaj.3049.
|
| [19] |
Yossepowitch O, Dalbagni G. Transitional cell carcinoma of the bladder in young adults: presentation, natural history and outcome. J Urol 2002; 168:61-6.
pmid: 12050493
|
| [20] |
Nomikos M, Pappas A, Kopaka ME, Tzoulakis S, Volonakis I, Stavrakakis G, et al. Urothelial carcinoma of the urinary bladder in young adults: presentation, clinical behavior and outcome. Adv Urol 2011; 2011:480738. https://doi.org/10.1155/2011/480738.
|
| [21] |
Babjuk M, Burger M, Capoun O, Cohen D, Compérat EM, Dominguez Escrig JL, et al. European Association of Urology guidelines on non-muscle-invasive bladder cancer (Ta, T1, and carcinoma in situ). Eur Urol 2022; 81:75-94.
|
| [22] |
Miyamoto H, Miller JS, Fajardo DA, Lee TK, Netto GJ, Epstein JI. Non-invasive papillary urothelial neoplasms: the 2004 WHO/ISUP classification system. Pathol Int 2010; 60:1-8.
doi: 10.1111/j.1440-1827.2009.02477.x
pmid: 20055945
|
| [23] |
Burger M, Catto JW, Dalbagni G, Grossman HB, Herr H, Karakiewicz P, et al. Epidemiology and risk factors of urothelial bladder cancer. Eur Urol 2013; 63:234-41.
doi: 10.1016/j.eururo.2012.07.033
pmid: 22877502
|
| [24] |
Lin N, Wu Y, Lin YZ, Tao X, Chen SH, Ke Z, et al. Risk factors for upper tract urothelial recurrence following local excision of bladder cancer. Cancer Med 2018; 7:4098-103.
|
| [25] |
Ravvaz K, Walz ME, Weissert JA, Downs TM. Predicting nonmuscle invasive bladder cancer recurrence and progression in a United States population. J Urol 2017; 198:824-31.
doi: S0022-5347(17)54785-0
pmid: 28433642
|
| [26] |
Witjes JA. Follow-up in non-muscle invasive bladder cancer: facts and future. World J Urol 2021; 39:4047-53.
doi: 10.1007/s00345-020-03569-2
pmid: 33367941
|
| [27] |
Ali-El-Dein B, Sarhan O, Hinev A, Ibrahiem el HI, Nabeeh A, Ghoneim MA. Superficial bladder tumours: analysis of prognostic factors and construction of a predictive index. BJU Int 2003; 92:393-9.
pmid: 12930428
|
| [28] |
Palou J, Hernández C, Solsona E, Abascal R, Burgués JP, Rioja C, et al. Effectiveness of hexaminolevulinate fluorescence cystoscopy for the diagnosis of non-muscle-invasive bladder cancer in daily clinical practice: a Spanish multicentre observational study. BJU Int 2015; 116:37-43.
doi: 10.1111/bju.13020
pmid: 25496450
|
| [29] |
Lu M, Chen S, Zhou Q, Wang L, Peng T, Wang G. Predicting recurrence of nonmuscle-invasive bladder cancer (Ta-T1): a study based on 477 patients. Medicine 2019; 98:e16426. https://doi.org/10.1097/MD.0000000000016426.
|
| [30] |
Bachir BG, Kassouf W. Causeeeffect? Understanding the risk factors associated with bladder cancer. Expert Rev Anticancer Ther 2012; 12:1499-502.
|
| [31] |
Zlotta AR, Roumeguere T, Kuk C, Alkhateeb S, Rorive S, Lemy A, et al. Select screening in a specific high-risk population of patients suggests a stage migration toward detection of nonmuscle- invasive bladder cancer. Euro urol 2011; 59:1026-31.
|
| [32] |
Freedman ND, Silverman DT, Hollenbeck AR, Schatzkin A, Abnet CC. Association between smoking and risk of bladder cancer among men and women. JAMA 2011 17; 306:737-45.
doi: 10.1001/jama.2011.1142
pmid: 21846855
|
| [33] |
Shiota M, Takeuchi A, Yokomizo A, Kashiwagi E, Tatsugami K, Kuroiwa K, et al. Androgen receptor signaling regulates cell growth and vulnerability to doxorubicin in bladder cancer. J Urol 2012; 188:276-86.
doi: 10.1016/j.juro.2012.02.2554
pmid: 22608749
|
| [34] |
Ogihara K, Kikuchi E, Yuge K, Ito Y, Tanaka N, Matsumoto K, et al. Refraining from smoking for 15 years or more reduced the risk of tumor recurrence in non-muscle invasive bladder cancer patients. Ann Surg Oncol 2016; 23:1752-9.
|
| [35] |
Kurz KR, Pitts WR, Vaughan ED Jr. The natural history of patients less than 40 years old with bladder tumors. J Urol 1987; 137:395-7.
doi: 10.1016/s0022-5347(17)44046-8
pmid: 3820365
|
| [36] |
Ferro M, Vartolomei MD, Russo GI, Cantiello F, Farhan ARA, Terracciano D, et al. An increased bodymass index is associated with a worse prognosis in patients administered BCG immunotherapy for T1 bladder cancer. World J Urol 2019; 37:507-14.
|
| [37] |
Evers J, Grotenhuis AJ, Aben KKH, Kiemeney L, Vrieling A. No clear associations of adult BMI and diabetes mellitus with non-muscle invasive bladder cancer recurrence and progression. PLoS One 2020; 15:e0229384. https://doi.org/10.1371/journal.pone.0229384.
|
| [38] |
Wojciechowska J, Krajewski W, Bolanowski M, Kr?cicki T, Zatoński T. Diabetes and cancer: a review of current knowledge. Exp Clin Endocrinol Diabetes 2016; 124:263-75.
|
| [39] |
Hu J, Chen JB, Cui Y, Zhu YW, Ren WB, Zhou X, et al. Association of metformin intake with bladder cancer risk and oncologic outcomes in type 2 diabetes mellitus patients: a systematic review and meta-analysis. Medicine 2018; 97:e11596. https://doi.org/10.1097/MD.0000000000011596.
|
| [40] |
Kocan H, Kadihasanoglu M. Age and sex do not affect first year recurrence in patients with non-muscle invasive bladder cancer. Folia Med 2021; 63:242-6.
|
| [41] |
Yuge K, Kikuchi E, Matsumoto K, Takeda T, Miyajima A, Oya M. Could patient age influence tumor recurrence rate in nonmuscle- invasive bladder cancer patients treated with BCG immunotherapy? Jpn J Clin Oncol 2011; 41:565-70.
|
| [42] |
Ferro M, Chiujdea S, Musi G, Lucarelli G, Del Giudice F, Hurle R, et al. Impact of age on outcomes of patients with pure carcinoma in situ of the bladder: multi-institutional cohort analysis. Clin Genitourin Cancer 2022; 20:e166-72. https://doi.org/10.1016/j.clgc.2021.12.005.
|
| [43] |
Serretta V, Pavone C, Ingargiola GB, Daricello G, Allegro R, Pavone-Macaluso M. TUR and adjuvant intravesical chemotherapy in T1G3 bladder tumors: recurrence, progression and survival in 137 selected patients followed up to 20 years. Eur Urol 2004; 45:730-6.
|
| [44] |
Thalmann GN, Markwalder R, Shahin O, Burkhard FC, Hochreiter WW, Studer UE. Primary T1G3 bladder cancer: organ preserving approach or immediate cystectomy? J Urol 2004; 172:70-5.
doi: 10.1097/01.ju.0000132129.87598.3b
pmid: 15201740
|
| [45] |
Contieri R, Hurle R, Paciotti M, Casale P, Saita A, Porpiglia F, et al. Accuracy of the European Association of Urology (EAU) NMIBC 2021 scoring model in predicting progression in a large cohort of HG T1 NMIBC patients treated with BCG Minerva Urol Nephrol 2022 2023; 75:180-7.
|
| [46] |
Ho P, Moran GW, Wang V, Li G, Virk RK, McKiernan JM, et al. The effect of tumor grade heterogeneity on recurrence in non-muscle invasive bladder cancer. Urol Oncol 2022; 40:e11-6. https://doi.org/10.1016/j.urolonc.2021.07.003.
|
| [47] |
Ferro M, Barone B, Crocetto F, Lucarelli G, Busetto GM, Del Giudice F, et al. Predictive clinico-pathological factors to identify BCG, unresponsive patients, after re-resection for T1 high grade non-muscle invasive bladder cancer. Urol Oncol 2022; 40:e13-20. https://doi.org/10.1016/j.urolonc.2022.05.016.
|
| [1] |
Jonathan Rosenfeld, Devin Boehm, Aidan Raikar, Devyn Coskey, Matthew Lee, Emily Ji, Ziho Lee. A review of complications after ureteral reconstruction[J]. Asian Journal of Urology, 2024, 11(3): 348-356. |
| [2] |
Noura F. Abbas, Marc R. Aoude, Hampig R. Kourie, Humaid O. Al-Shamsi. Uncovering the epidemiology of bladder cancer in the Arab world: A review of risk factors, molecular mechanisms, and clinical features[J]. Asian Journal of Urology, 2024, 11(3): 406-422. |
| [3] |
Nikita Shrivastava, Rahul Jena, Deepak Prakash Bhirud, Mahendra Singh, Gautam Ram Choudhary, Arjun Singh Sandhu. Analysis of the urethral stricture score and patient-related factors as predictors of outcomes following oral mucosal graft urethroplasty[J]. Asian Journal of Urology, 2024, 11(3): 473-479. |
| [4] |
Ahmed M. Abdel Gawad, Abhijit Patil, Abhishek Singh, Arvind P. Ganpule, Ravindra B. Sabnis, Mahesh R. Desai. Long-term outcomes of urethral balloon dilation for anterior urethral stricture: A prospective cohort study[J]. Asian Journal of Urology, 2024, 11(3): 480-485. |
| [5] |
Herney Andrés García-Perdomo, Angélica María Dávila-Raigoza, Fernando Korkes. Metabolomics for the diagnosis of bladder cancer: A systematic review[J]. Asian Journal of Urology, 2024, 11(2): 221-241. |
| [6] |
Angelo Territo, Alessandro Uleri, Andrea Gallioli, Josep Maria Gaya, Paolo Verri, Giuseppe Basile, Alba Farré, Alejandra Bravo, Alessandro Tedde, Óscar Rodríguez Faba, Joan Palou, Alberto Breda. Robot-assisted oncologic pelvic surgery with Hugo™ robot-assisted surgery system: A single-center experience[J]. Asian Journal of Urology, 2023, 10(4): 461-466. |
| [7] |
Kerri R. Beckmann, Michael E. O'Callaghan, Andrew D. Vincent, Kim L. Moretti, Nicholas R. Brook. Clinical outcomes for men with positive surgical margins after radical prostatectomy—results from the South Australian Prostate Cancer Clinical Outcomes Collaborative community-based registry[J]. Asian Journal of Urology, 2023, 10(4): 502-511. |
| [8] |
Chong Ma,Shuxiong Zeng,Lihe Dai,Huan Han,Ruixiang Song,Jinshan Xu,Xing Ai,Chuanliang Xu. The natural course of bacillus Calmette-Guérin induced bladder lesions: A long-term follow-up study and systematic review[J]. Asian Journal of Urology, 2023, 10(3): 356-363. |
| [9] |
Zahid Lepara,Jasmin Alić,Orhan Lepara,Hajrudin Spahović,Almir Fajkić. Antioxidant status in patients with bladder cancer regarding cancer stage and grade[J]. Asian Journal of Urology, 2023, 10(2): 182-188. |
| [10] |
Victor Chalfant,Michael L. BluteJr.,Peter Silberstein. Treatment trends of muscle invasive bladder cancer: Evidence from the Surveillance, Epidemiology, and End Results database, 1988 to 2013[J]. Asian Journal of Urology, 2023, 10(1): 9-18. |
| [11] |
Junjie Fan,Hua Liang,Jinhai Fan,Lei Li,Guanjun Zhang,Xinqi Pei,Tao Yang,Dalin He,Kaijie Wu. Diagnostic accuracy of cystoscopic biopsy for tumour grade in outpatients with urothelial carcinoma of the bladder and the risk factors of upgrading[J]. Asian Journal of Urology, 2023, 10(1): 19-26. |
| [12] |
Umberto Carbonara,Daniele Amparore,Cosimo Gentile,Riccardo Bertolo,Selcuk Erdem,Alexandre Ingels,Michele Marchioni,Constantijn H.J. Muselaers,Onder Kara,Laura Marandino,Nicola Pavan,Eduard Roussel,Angela Pecoraro,Fabio Crocerossa,Giuseppe Torre,Riccardo Campi,Pasquale Ditonno. Current strategies to diagnose and manage positive surgical margins and local recurrence after partial nephrectomy[J]. Asian Journal of Urology, 2022, 9(3): 227-242. |
| [13] |
Chinna Babu Dracham,Narendra Kumar,Santosh Kumar,Arun Elangovan,Budhi Singh Yadav,Ravimohan S. Mavuduru,Anupam Lal,Pramod K. Gupta,Rakesh Kapoor. A phase II study of neoadjuvant chemotherapy followed by organ preservation in patients with muscle-invasive bladder cancer[J]. Asian Journal of Urology, 2022, 9(3): 318-328. |
| [14] |
Yuvaraja B. Thyavihally,Preetham Dev,Santosh Waigankar,Abhinav Pednekar,Nevitha Athikari,Abhijit Raut,Archan Khandekar,Naresh Badlani,Ashishkumar Asari. Intravesical bacillus Calmette-Guerin (BCG) in treating non-muscle invasive bladder cancer—analysis of adverse effects and effectiveness of two strains of BCG (Danish 1331 and Moscow-I)[J]. Asian Journal of Urology, 2022, 9(2): 157-164. |
| [15] |
Liang G. Qu,Gregory Jack,Marlon Perera,Melanie Evans,Sue Evans,Damien Bolton,Nathan Papa. Impact of delay from transperineal biopsy to radical prostatectomy upon objective measures of cancer control[J]. Asian Journal of Urology, 2022, 9(2): 170-176. |
|
|
|
|
