External validation of EORTC risk scores to predict recurrence after transurethral resection of brazilian patients with non-muscle invasive bladder cancer stages Ta and T1

Abstract

Validate the EORTC risk tables in Brazilian patients with NMIBC.Methods:205 patients were analyzed. The 6 parameters analyzed were: histologic grading, pathologic stage, size and number of tumors, previous recurrence rate and concomitant CIS. The time for first recurrence (TFR), risk score and probability of recurrence were calculated and compared to the probabilities obtained from EORTC risk tables. C-index was calculated and accuracy of EORTC tables was analyzed. Results: pTa was presented in 91 (44.4%) patients and pT1 in 114 (55.6%). Ninety-seven (47.3%) patients had solitary tumor, and 108 (52.7%) multiple tumors. One hundred and three (50.2%) patients had tumors smaller than 3 cm and 102 (40.8%) had bigger than 3 cm. Concomitant CIS was observed in 21 (10.2%) patients. Low grade was presented in 95 (46.3%) patients, and high grade in 110 (53.7%). Intravesical therapy was utilized in 105 (56.1%) patients. Recurrence was observed in 117 (57.1%) patients and the mean TFR was 14,2 ± 7,3 months. C-index was 0,72 for 1 year and 0,7 for 5 years. The recurrence risk was 28,8% in 1 year and 57,1% in 5 years, independently of the scoring risk. In our population, the EORTC risk tables overestimated the risk of recurrence in 1 year and underestimated in 5 years.Conclusion:The validation of the EORTC risk tables in Brazilian patients with NMIBC was satisfactory and should be stimulated to predict recurrence, although these may overestimated the risk of recurrence in 1 year and underestimated in 5 years.

Predicting Recurrence and Progression in Patients with Non-Muscle-Invasive Bladder Cancer: Systematic Review on the Performance of Risk Stratification Models

“…Twenty of the 25 included studies were judged to be at high risk of bias (RoB) [ 5, 12–34 ], and only one article was judged to be at low RoB [ 6 ]. Overall high RoB was mainly caused by high RoB in the analysis domain (13/25 studies) [ 12–14, 17–19, 24, 26–28, 31, 32, 34 ], followed by a high (7/25 studies) [ 14, 15, 20, 22, 24, 29, 33 ] and unclear (11/25 studies) [ 5, 12, 16, 17, 23, 26–28, 30–32 ] RoB in the outcomes domain. The other two domains contributed little to the overall high RoB ( Fig.…”

“…Eleven studies were multi-institutional. Three studies consisted of prediction model development without external validation [ 5, 6, 30 ] and 22 studies were external validations of existing models [ 12–29, 31–34 ].…”