Viktor Soukup1, Otakar Čapoun2, Daniel Cohen3, Virginia Hernández4, Maximilian Burger5, Eva Compérat6, Paolo Gontero7, Thomas Lam8, A Hugh Mostafid9, Joan Palou10, Bas W G van Rhijn11, Morgan Rouprêt12, Shahrokh F Shariat13, Richard Sylvester14, Yuhong Yuan15, Richard Zigeuner16, Marek Babjuk17. 1. Department of Urology, General Teaching Hospital and 1st Faculty of Medicine, Charles University in Prague, Prague, Czech Republic. Electronic address: viktor.soukup@seznam.cz. 2. Department of Urology, General Teaching Hospital and 1st Faculty of Medicine, Charles University in Prague, Prague, Czech Republic. 3. Department of Urology, Royal Free London NHS Foundation Trust, London, UK. 4. Department of Urology, Hospital Universitario Fundación de Alcorcón, Madrid, Spain. 5. Department of Urology and Paediatric Urology, Julius-Maximilians-University Würzburg, Würzburg, Germany. 6. Department of Pathology, Hôpital Tenon, Assistance Publique Hopitaux de Paris, Institut Universitaire de Cancérologie GRC5, Sorbonne University, Paris, France. 7. Department of Surgical Sciences, Urology, University of Turin, Turin, Italy. 8. Academic Urology Unit, University of Aberdeen, Scotland, UK. 9. Department of Urology, Royal Surrey County Hospital, Guildford, UK. 10. Department of Urology, Fundació Puigvert, Universitat Autònoma de Barcelona, Barcelona, Spain. 11. Department of Surgical Oncology (Urology), Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands. 12. Department of Urology, Hopital Pitié-Salpêtrière, Assistance Publique Hôpitaux de Paris, Institut Universitaire de Cancérologie GRC5, Sorbonne University, Paris, France. 13. Department of Urology, Vienna General Hospital, Medical University of Vienna, Vienna, Austria. 14. EAU Guidelines Office Board, European Association of Urology, Arnhem, The Netherlands. 15. Department of Medicine, Health Science Centre, McMaster University, Hamilton, Ontario, Canada. 16. Department of Urology, Medizinische Universität Graz, Graz, Austria. 17. Department of Urology, Motol University Hospital and Second Faculty of Medicine, Charles University, Prague, Czech Republic.
Abstract
CONTEXT: This review focuses on the most widely used risk stratification and prediction tools for non-muscle-invasive bladder cancer (NMIBC). OBJECTIVE: To assess the clinical use and relevance of risk stratification and prediction tools to enhance clinical decision making and counselling of patients with NMIBC. EVIDENCE ACQUISITION: The most frequent, currently used risk stratification tools and prognostic models for NMIBC patients were identified by the members of the European Association of Urology (EAU) Guidelines Panel on NMIBC. EVIDENCE SYNTHESIS: The 2006 European Organization for Research and Treatment of Cancer (EORTC) risk tables are the most widely used and validated tools for risk stratification and prognosis prediction in NMIBC patients. The EAU risk categories constitute a simple alternative to the EORTC risk tables and can be used for comparable risk stratification. In the subgroup of NMIBC patients treated with a short maintenance schedule of bacillus Calmette-Guerin (BCG), the Club Urológico Español de Tratamiento Oncológico (CUETO) scoring model is more accurate than the EORTC risk tables. Both the EORTC risk tables and the CUETO scoring model overestimate the recurrence and progression risks in patients treated according to current guidelines. The new concept of conditional recurrence and progression estimates is very promising during follow-up but should be validated. CONCLUSIONS: Risk stratification and prognostic models enable outcome comparisons and standardisation of treatment and follow-up. At present, none of the available risk stratification and prognostic models reflects current standards of treatment. The EORTC risk tables and CUETO scoring model should be updated with previously unavailable data and recalculated. PATIENT SUMMARY: Non-muscle-invasive bladder cancer is a heterogeneous disease. A risk-based therapeutic approach is recommended. We present available risk stratification and prediction tools and the degree of their validation with the aim to increase their use in everyday clinical practice.
CONTEXT: This review focuses on the most widely used risk stratification and prediction tools for non-muscle-invasive bladder cancer (NMIBC). OBJECTIVE: To assess the clinical use and relevance of risk stratification and prediction tools to enhance clinical decision making and counselling of patients with NMIBC. EVIDENCE ACQUISITION: The most frequent, currently used risk stratification tools and prognostic models for NMIBC patients were identified by the members of the European Association of Urology (EAU) Guidelines Panel on NMIBC. EVIDENCE SYNTHESIS: The 2006 European Organization for Research and Treatment of Cancer (EORTC) risk tables are the most widely used and validated tools for risk stratification and prognosis prediction in NMIBC patients. The EAU risk categories constitute a simple alternative to the EORTC risk tables and can be used for comparable risk stratification. In the subgroup of NMIBC patients treated with a short maintenance schedule of bacillus Calmette-Guerin (BCG), the Club Urológico Español de Tratamiento Oncológico (CUETO) scoring model is more accurate than the EORTC risk tables. Both the EORTC risk tables and the CUETO scoring model overestimate the recurrence and progression risks in patients treated according to current guidelines. The new concept of conditional recurrence and progression estimates is very promising during follow-up but should be validated. CONCLUSIONS: Risk stratification and prognostic models enable outcome comparisons and standardisation of treatment and follow-up. At present, none of the available risk stratification and prognostic models reflects current standards of treatment. The EORTC risk tables and CUETO scoring model should be updated with previously unavailable data and recalculated. PATIENT SUMMARY:Non-muscle-invasive bladder cancer is a heterogeneous disease. A risk-based therapeutic approach is recommended. We present available risk stratification and prediction tools and the degree of their validation with the aim to increase their use in everyday clinical practice.
Authors: M C Kriegmair; S Hein; D S Schoeb; H Zappe; R Suárez-Ibarrola; F Waldbillig; B Gruene; P-F Pohlmann; F Praus; K Wilhelm; C Gratzke; A Miernik; C Bolenz Journal: Urologe A Date: 2020-12-10 Impact factor: 0.639
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Authors: Mehdi Kardoust Parizi; Dmitry Enikeev; Petr V Glybochko; Veronika Seebacher; Florian Janisch; Harun Fajkovic; Piotr L Chłosta; Shahrokh F Shariat Journal: World J Urol Date: 2019-09-06 Impact factor: 4.226