EORTC Risk Model to Predict Progression in Patients with Non-Muscle-Invasive Bladder Cancer: Is It Safe to Use in Clinical Practice?

Wilson F S Busato Júnior, Gilberto Laurino Almeida, Carmen A P M Ribas, Jurandir M. Ribas Filho, Ottavio De Cobelli

Research output: Contribution to journalArticlepeer-review

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.

Original languageEnglish
Pages (from-to)176-182
Number of pages7
JournalClinical Genitourinary Cancer
Volume14
Issue number2
DOIs
Publication statusPublished - Apr 1 2016

Keywords

  • Non-muscle-invasive bladder cancer
  • Prediction
  • Progression
  • Recurrence
  • Validation

ASJC Scopus subject areas

  • Oncology
  • Urology

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