Wilson F S Busato Júnior1, Gilberto Laurino Almeida2, Carmen A P M Ribas3, Jurandir M Ribas Filho3, Ottavio De Cobelli4. 1. University of Vale do Itajaí, Itajaí, Brazil, Instituto Catarinense de Urologia (INCAU), Itajaí, Brazil. 2. University of Vale do Itajaí, Itajaí, Brazil, Instituto Catarinense de Urologia (INCAU), Itajaí, Brazil; Faculdade Evangélica do Paraná (FEPAR), Instituto de Pesquisas Médicas (IPEM), Curitiba, Brazil. Electronic address: glalmeida@ibest.com.br. 3. Faculdade Evangélica do Paraná (FEPAR), Instituto de Pesquisas Médicas (IPEM), Curitiba, Brazil. 4. University of Milan, Milan, Italy; Department of Urology, European Institute of Oncology (IEO), Milan, Italy.
Abstract
PURPOSE: To evaluate the validation of European Organization for Research and Treatment of Cancer (EORTC) risk tables to predict progression in Brazilian patients with non-muscle-invasive bladder cancer (NMIBC). PATIENTS AND METHODS: Two hundred five consecutively and prospectively selected patients with NMIBC who underwent transurethral resection were analyzed during 12 years. Six parameters were analyzed: tumor grade, size, and number, pT stage, previous recurrence rate, and carcinoma-in-situ. Time to progression, risk score, and progression probabilities were calculated and compared to probabilities obtained from the EORTC model. The C index was calculated, and accuracy was analyzed for external validation. RESULTS: A total of 152 patients had complete follow-up data, 36 died, and 17 were lost to follow-up. One hundred thirty-seven patients had primary tumors and 68 had recurrent tumors. Progression to muscle-invasive disease occurred in 42 patients (20.5%). Significant characteristics related to progression were male gender, pT1 stage, lesion size ≥ 3 cm, high grade of disease, and no combined intravesical therapy. Mean time to progression was 26.9 months; the 1-year progression rate was 3.4% and the 5-year rate was 19.1%. The C index was 0.86 at 1 year and 0.78 at 5 years. For calibration, 1- and 5-year progression rates were lower than the values predicted by EORTC risk tables, mainly in high-risk groups. Although the EORTC model overestimated the short- and long-term risk of progression, an overlapping of the confidence intervals between both populations was detected. CONCLUSION: The EORTC model successfully stratified progression risks in a Brazilian cohort, although it overestimated progression rates. This scoring system is useful in predicting progression of NMIBC; however, updating new risk markers is essential to improve risk classification and prediction of progression.
PURPOSE: To evaluate the validation of European Organization for Research and Treatment of Cancer (EORTC) risk tables to predict progression in Brazilian patients with non-muscle-invasive bladder cancer (NMIBC). PATIENTS AND METHODS: Two hundred five consecutively and prospectively selected patients with NMIBC who underwent transurethral resection were analyzed during 12 years. Six parameters were analyzed: tumor grade, size, and number, pT stage, previous recurrence rate, and carcinoma-in-situ. Time to progression, risk score, and progression probabilities were calculated and compared to probabilities obtained from the EORTC model. The C index was calculated, and accuracy was analyzed for external validation. RESULTS: A total of 152 patients had complete follow-up data, 36 died, and 17 were lost to follow-up. One hundred thirty-seven patients had primary tumors and 68 had recurrent tumors. Progression to muscle-invasive disease occurred in 42 patients (20.5%). Significant characteristics related to progression were male gender, pT1 stage, lesion size ≥ 3 cm, high grade of disease, and no combined intravesical therapy. Mean time to progression was 26.9 months; the 1-year progression rate was 3.4% and the 5-year rate was 19.1%. The C index was 0.86 at 1 year and 0.78 at 5 years. For calibration, 1- and 5-year progression rates were lower than the values predicted by EORTC risk tables, mainly in high-risk groups. Although the EORTC model overestimated the short- and long-term risk of progression, an overlapping of the confidence intervals between both populations was detected. CONCLUSION: The EORTC model successfully stratified progression risks in a Brazilian cohort, although it overestimated progression rates. This scoring system is useful in predicting progression of NMIBC; however, updating new risk markers is essential to improve risk classification and prediction of progression.
Authors: Murat Akand; Tim Muilwijk; Jan Cornelissen; Siska Van Bruwaene; Kathy Vander Eeckt; Frederic Baekelandt; Pieter Mattelaer; Raf Van Reusel; Ben Van Cleynenbreugel; Steven Joniau; Frank Van Der Aa Journal: Front Oncol Date: 2019-12-11 Impact factor: 6.244
Authors: Matteo Ferro; Marina Di Mauro; Sebastiano Cimino; Giuseppe Morgia; Giuseppe Lucarelli; Abdal Rahman Abu Farhan; Mihai Dorin Vartolomei; Angelo Porreca; Francesco Cantiello; Rocco Damiano; Gian Maria Busetto; Francesco Del Giudice; Rodolfo Hurle; Sisto Perdonà; Marco Borghesi; Pierluigi Bove; Riccardo Autorino; Nicolae Crisan; Michele Marchioni; Luigi Schips; Francesco Soria; Andrea Mari; Andrea Minervini; Alessandro Veccia; Michele Battaglia; Daniela Terracciano; Gennaro Musi; Giovanni Cordima; Matteo Muto; Vincenzo Mirone; Ottavio de Cobelli; Giorgio Ivan Russo Journal: Transl Androl Urol Date: 2021-02