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KMID : 1011820210620040408
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Investigative and Clinical Urology
2021 Volume.62 No. 4 p.408 ~ p.415
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Stratifying risk for multiple, recurrent, and large (≥3 cm) Ta, G1/G2 tumors in non-muscle-invasive bladder cancer
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Suh Jun-Gyo
Jung Jae-Hyun
Kwak Cheol
Kim Hyeon-Hoe
Ku Ja-Hyeon
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Abstract
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Purpose: The current stratification of risk groups regarding recurrence and progression of non-muscle-invasive bladder cancer (NMIBC) is problematic. We aimed to assess the long-term outcome and risk of multiple, recurrent, and large (≥3 cm) Ta, G1/G2 tumors after transurethral resection of the bladder tumor (TURBT).
Materials and Methods: We categorized 1,621 patients with NMIBC who underwent TURBT into four risk groups according to the European Association of Urology (EAU) guidelines as follows: low-risk, intermediate-risk, high-risk, and study group. The overall, cancer-specific, disease recurrence-free, and disease progression-free survival rates were estimated by using the Kaplan?Meier method. Then, the impact of risk group was assessed by using a multivariable Cox regression model.
Results: The study group comprised 52 patients (3.2%) within a mean follow-up of 64.8 months. The disease recurred and progressed in 41 (78.8%) and 7 (13.5%) patients, respectively. Among the four groups, the study group showed the highest risk for 10-year recurrence after TURBT. The disease progression risk in the study group was between that of the intermediate- and high-risk groups. Cancer-specific and all-cause deaths occurred in one and four patients in the study group, respectively. The study group had a higher risk for disease recurrence than did the high-risk group; however, it did not have a higher risk for disease progression than in the high-risk group.
Conclusions: Multiple, recurrent, and large (≥3 cm) Ta, G1/G2 tumors carry a higher risk for disease recurrence, but not progression, than in the EAU high-risk group of NMIBC.
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KEYWORD
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Outcome, Risk assessment, Urinary bladder neoplasms
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