Assessment of a European Bladder Cancer Predictive Model for Non-Muscle Invasive Bladder Cancer in an Australian Cohort

Abstract

Background and Objectives: To validate the European Organization for Research and Treatment of Cancer (EORTC) model using an Australian cohort and to identify variables within our cohort that may predict non-muscle invasive bladder cancer (NMIBC) recurrence and progression. Methods: A retrospective chart review of patients undergoing transurethral resection of bladder tumour (TURBT) at a single academic institution between 1995 and 2015 was performed (n = 366). Only patients with available TURBT pathology having initial Ta or T1 disease were included (n = 255).EORTC risk groups were calculated for individual patients and compared to actual recurrence rates using a binomial method comparing observed and expected proportions. Results: In our cohort of 255 patients, there were 209 men and 46 women, with a median age of 69 years (range 18-93). Intravesical therapy was given to 59% (n = 152). In total, 142 patients (56%) experienced cancer recurrence, with median recurrence and progression free survival at 11 months and 25.5 months respectively.Comparison of EORTC estimates to actual recurrence proportions at 1, 3 and 5 years showed the EORTC calculator underestimated the actual recurrence that occurred. However, only EORTC group "score 1-4" estimate was statistically significant compared to the actual recurrence (at 1 year, predicted 24% vs actual 33%, p < 0.001). Conclusion:In validating the EORTC risk calculator in our Australian cohort, we found the calculator underestimated NMIBC recurrence for most of our patients. Longer follow-up time and a larger sample size may assist with validation but true differences in population and treatment may exist. Our results suggest for now, care should be exercised when applying these risk tables to an Australian population.

Oncological impact of cystoscopic findings in non‐muscle‐invasive bladder cancer: a meta‐analysis

“…After screening, a full‐text review was performed for 201 articles. According to the inclusion criteria, we finally identified 72 studies comprising 28 139 patients eligible for the meta‐analysis [12–83]. The demographics of each included study are shown in Table 1 and Table S2.…”

“…Of the 72 included studies, five included only Ta NMIBC patients [12–16], and 26 studies included only T1 NMIBC patients [17–42]. The other 41 studies included both Ta and T1 patients [43–83].…”