High-grade Ta Tumors Unresponsive To BCG Progress Fast And M
An institutional review of all patients who received adequate BCG from 2000–2018 was conducted. EAU 2021 prognostic risk groups were used to stratify patients. When patients with Ta tumors were stratified into IR and HR, 37 (16%) had IR low-grade (LG) Ta, 92 (40%) had IR HG Ta and 101 (44%) had HR HG Ta tumors. BCG unresponsiveness developed in 13% of HR HG Ta tumors and 14% of IR HG Ta tumors compared to 0.0% of IR LG Ta tumors (p=0.003). While no patients with IR LG Ta tumors progressed, progression rates were similar in HR HG Ta and IR HG Ta tumors (T2: 5.9% and 6.5%; T1: 13% and 13%, respectively). Rates of recurrence, BCG unresponsiveness, and progression were similar, irrespective of a number of EAU risk factors present (p=0.9, p=0.8, and p=0.9, respectively). All HG Ta tumors, regardless of EAU risk stratification, have an inferior response to BCG and increased rates of progression compared to IR LG Ta tumors. EAU clinical risk factors did not improve the prediction of oncologic outcomes among HG Ta patients who received adequate BCG. These data support the consideration of all HG tumors as high risk.

Source: https://www.auajournals.org/doi/10.1097/JU.0000000000002678