T1 Bladder Cancer: Comparison of the Prognostic Impact of Two Substaging Systems on Disease Recurrence and Progression and Suggestion of a Novel Nomogram

Asimakopoulos, Anastasios D.; Colalillo, Gaia; Telesca, Rossana; Mauriello, Alessandro; Miano, Roberto; Stasi, Savino M. Di; Germani, Stefano; Agrò, Enrico Finazzi; Petrozza, Vincenzo; Caruso, Gianluca; Carbone, Antonio; Pastore, Antonio Luigi; Fuschi, Andrea

doi:10.3389/fsurg.2021.704902

Cited by 6 publications

(18 citation statements)

References 34 publications

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“…In contrast, our study used CSS as the outcome and only included DMUBC, which may be the main reason for the different results. Asimakopoulos et al performed a retrospective study and developed a prognostic nomogram that confirmed T1 substaging, tumor size and tumor location as independent prognosticators of five-years disease-free survival in T1 bladder cancer patients[ 20 ]. Additionally, Tian et al included TCBC patients from SEER database.…”

Section: Discussionmentioning

confidence: 99%

Constructing and validating nomograms to predict risk and prognostic factors of distant metastasis in urothelial bladder cancer patients: a population-based retrospective study

Chen

Luo

et al. 2022

BMC Urol

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Background Urothelial carcinoma is the most common type of bladder cancer worldwide and it has a poor prognosis for patients with distant metastasis. Nomograms are frequently used in clinical research, but no research has evaluated the diagnostic and prognostic factors of distant metastasis in urothelial bladder cancer (UBC). Methods The Surveillance, Epidemiology, and End Results database was used to analyze all patients diagnosed with UBC between 2000 and 2017. Lasso regression was used to identify the potential risk predictive factors for distant metastasis in UBC. Univariate and multivariate Cox proportional hazard regression analyses were performed to determine independent prognostic factors for distant metastasis urothelial bladder cancer (DMUBC). Subsequently, two nomograms were constructed based on the above models. The receiver operating characteristic (ROC), and calibration curves were performed to evaluate the two nomograms. Results The study included 73,264 patients with UBC, with 2,129 (2.9%) having distant metastasis at the time of diagnosis. In the diagnostic model, tumor size, histologic type, and stage N and T were all important risk predictive factors for distant metastasis of UBC. In the prognostic model, age, tumor size, surgery, and chemotherapy were independent factors affecting the prognosis of DMUBC. DCA, ROC, calibration, and Kaplan–Meier (K–M) survival curves reveal that the two nomograms can effectively predict the diagnosis and prognosis of DMUBC. Conclusion The developed nomograms are practical methods for predicting the occurrence risk and prognosis of distant metastasis urothelial bladder cancer patients, which may benefit the clinical decision-making process.

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Section: Discussionmentioning

confidence: 99%

Constructing and validating nomograms to predict risk and prognostic factors of distant metastasis in urothelial bladder cancer patients: a population-based retrospective study

Chen

Luo

et al. 2022

BMC Urol

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“…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].…”

Section: Resultsmentioning

confidence: 99%

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

et al. 2023

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Objective To assess the association between cystoscopic findings and oncological outcomes in patients with non‐muscle‐invasive bladder cancer (NMIBC) given that the oncological impact of quantity and quality assessment of tumours with cystoscopy has not been well verified. Methods Multiple databases were queried in May 2022 for studies investigating the association of oncological outcomes, such as recurrence‐free (RFS), progression‐free (PFS), and cancer‐specific survival (CSS), with cystoscopic findings, including multiplicity, size, and gross appearance of tumours in patients with NMIBC. Results Overall, 73 studies comprising 28 139 patients were eligible for the meta‐analysis. Tumour multiplicity was associated with worse RFS (pooled hazard ratio [HR] 1.61, 95% confidence interval [CI] 1.48–1.74) and PFS (pooled HR 1.44, 95% CI 1.18–1.76) in NMIBC patients (including both Ta and T1). Tumour size (≥3 cm) was associated with worse RFS (pooled HR 1.97, 95% CI 1.69–2.30) and PFS (pooled HR 1.81, 95% CI 1.52–2.15) in NMIBC patients. In patients with T1 bladder cancer (BCa), tumour multiplicity and size (≥3 cm) were also associated with worse RFS, PFS and CSS. By contrast, among patients treated with bacillus Calmette‐Guérin (BCG), tumour multiplicity was not associated with worse RFS, and tumour size (≥3 cm) was not associated with worse PFS. Sessile tumours were associated with worse RFS (pooled HR 2.14, 95% CI 1.52–3.01) and PFS (pooled HR 2.17, 95% CI 1.42–3.32) compared to pedunculated tumours. Compared to papillary tumours, solid tumours were associated with worse RFS (pooled HR 1.84, 95% CI 1.25–2.72) and PFS (pooled HR 3.06, 95% CI 2.31–4.07) in NMIBC patients, and CSS in T1 BCa patients (pooled HR 2.32, 95% CI 1.63–3.30). Conclusions Cystoscopic findings, including tumour multiplicity, size, and gross appearance, strongly predict oncological outcomes in NMIBC patients. Cystoscopic visual features can help in the decision‐making process regarding the timeliness and extent of tumour resection as well as future management such as intravesical therapy.

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“…Most studies on semiquantitative methods included in our comprehensive literature review summarizing over 3700 patients showed an association with progressionfree survival or cancer-specific survival. 12,18,32,[44][45][46][47][48]51,52 Only 7% of studies on T1 subcategorization failed to show such an association, 13,14,20,26,36,39,44 most of which applied histoanatomic methods. Studies, comparing head-to-head histoanatomic and semiquantitative methodology also revealed a better performance in terms of prognostic impact for the latter.…”

Section: Discussionmentioning

confidence: 99%

“…Emerging data support T1 subcategorization as a predictor of oncological outcome 2–54 . Several studies have been conducted to identify the prognostic role of lamina propria invasion and to determine the best method to assess T1 subcategorization 9–54 . The 2 main approaches applied for bladder T1 subcategorization are histoanatomic methods using the presence of muscularis mucosae (MM) as a landmark, and (semi)quantitative methods using ocular micrometer or high-power fields–based assessment of extent of invasion 9–54 .…”

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confidence: 99%

International Society of Urological Pathology (ISUP) Consensus Conference on Current Issues in Bladder Cancer

Lopez-Beltran,

Raspollini,

Hansel

et al. 2023

American Journal of Surgical Pathology

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Emerging data on T1 bladder cancer subcategorization (aka substaging) suggests a correlation with oncological outcomes. The International Society of Urological Pathology (ISUP) organized the 2022 consensus conference in Basel, Switzerland to focus on current issues in bladder cancer and tasked working group 3 to make recommendations for T1 subcategorization in transurethral bladder resections. For this purpose, the ISUP developed and circulated a survey to their membership querying approaches to T1 bladder cancer subcategorization. In particular, clinical relevance, pathological reporting, and endorsement of T1 subcategorization in the daily practice of pathology were surveyed. Of the respondents of the premeeting survey, about 40% do not routinely report T1 subcategory. We reviewed literature on bladder T1 subcategorization, and screened selected articles for clinical performance and practicality of T1 subcategorization methods. Published literature offered evidence of the clinical rationale for T1 subcategorization and at the conference consensus (83% of conference attendants) was obtained to report routinely T1 subcategorization of transurethral resections. Semiquantitative T1 subcategorization was favored (37%) over histoanatomic methods (4%). This is in line with literature findings on practicality and prognostic impact, that is, a shift of publications from histoanatomic to semiquantitative methods or by reports incorporating both methodologies is apparent over the last decade. However, 59% of participants had no preference for either methodology. They would add a comment in the report briefly stating applied method, interpretation criteria (including cutoff), and potential limitations. When queried on the terminology of T1 subcategorization, 34% and 20% of participants were in favor of T1 (microinvasive) versus T1 (extensive) or T1 (focal) versus T1 (nonfocal), respectively.

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T1 Bladder Cancer: Comparison of the Prognostic Impact of Two Substaging Systems on Disease Recurrence and Progression and Suggestion of a Novel Nomogram

Cited by 6 publications

References 34 publications

Constructing and validating nomograms to predict risk and prognostic factors of distant metastasis in urothelial bladder cancer patients: a population-based retrospective study

Constructing and validating nomograms to predict risk and prognostic factors of distant metastasis in urothelial bladder cancer patients: a population-based retrospective study

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

International Society of Urological Pathology (ISUP) Consensus Conference on Current Issues in Bladder Cancer

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