Intermediate-risk (IR) non-muscle-invasive bladder cancer (NMIBC) encompasses a broad spectrum of disease, with heterogeneous outcomes in terms of disease recurrence and progression. The International Bladder Cancer Group (IBCG) recently proposed an updated scoring model for IR substratification that is based on five key risk factors. Our aim was to provide a clinical validation of the IBCG scoring system and substratification model for IR NMIBC.
This was an international multicenter retrospective study. Patients diagnosed with IR NMIBC between 2012 and 2022 and treated with transurethral resection of the bladder and adjuvant intravesical chemotherapy were included. According to the presence or absence of risk factors, patients with IR NMIBC were further categorized in IR-low (no risk factors), IR-intermediate (1-2 risk factors), and IR-high (≥3 risk factors) groups. The 1-yr and 3-yr rates for recurrence-free survival (RFS) and progression-free survival (PFS) were evaluated for each subgroup. Cox regression analyses were used to compare oncological outcomes between the groups.
Of the 677 patients with IR NMIBC included in the study, 231 (34%), 364 (54%), and 82 (12%) were categorized in the IR-low, IR-intermediate, and IR-high groups, respectively. There were significant differences in RFS and PFS rates between these groups.
We provide the first clinical validation of the IBCG scoring system and model for substratification of IR NMIBC.
Our study demonstrates that patients with intermediate-risk non-muscle-invasive bladder cancer can be correctly classified into three distinct subgroups according to their risk of both disease recurrence and progression. Our results support use of this scoring system in clinical practice.
European urology oncology. 2024 Jun 20 [Epub ahead of print]
Francesco Soria, Matteo Rosazza, Simone Livoti, Marco Moschini, Mario De Angelis, Francesco Del Giudice, Renate Pichler, Rodolfo Hurle, Stefano Mancon, Diego M Carrion, Wojciech Krajewski, Laura S Mertens, David D'Andrea, Andrea Mari, Fabrizio Di Maida, Daniele Dutto, Fulvia Colucci, Giulia Casale, Giorgia Fertitta, Ekaterina Laukhtina, Simone Albisinni, Benjamin Pradere, Jeremy Y C Teoh, Shahrokh F Shariat, Alberto Briganti, Ashish M Kamat, Paolo Gontero
Division of Urology, Department of Surgical Sciences, Torino School of Medicine, Torino, Italy. Electronic address: ., Division of Urology, Department of Surgical Sciences, Torino School of Medicine, Torino, Italy., Division of Experimental Oncology/Unit of Urology, Urological Research Institute, IRCCS Ospedale San Raffaele, Milan, Italy., Department of Maternal Infant and Urologic Sciences, Sapienza University of Rome, Policlinico Umberto I Hospital, Rome, Italy., Department of Urology, Comprehensive Cancer Center Innsbruck, Medical University of Innsbruck, Innsbruck, Austria., Department of Urology, Humanitas Clinical and Research Hospital, Rozzano, Italy., Department of Urology, Torrejon University Hospital, Madrid, Spain., Department of Urology and Oncologic Urology, Wroclaw Medical University, Wroclaw, Poland., Department of Urology, Netherlands Cancer Institute, Amsterdam, The Netherlands., Department of Urology, Comprehensive Cancer Center, Vienna General Hospital, Medical University of Vienna, Vienna, Austria., Unit of Oncologic Minimally-Invasive Urology and Andrology, Department of Urology, Careggi Hospital, University of Florence, Florence, Italy., Unit of Urology, Department of Surgical Sciences, Tor Vergata University Hospital, Tor Vergata University of Rome, Rome, Italy., Department of Urology, UROSUD, La Croix du Sud Hospital, Quint Fonsegrives, France., S.H. Ho Urology Centre, Department of Surgery, The Chinese University of Hong Kong, Hong Kong, China., Department of Urology, Comprehensive Cancer Center, Vienna General Hospital, Medical University of Vienna, Vienna, Austria; Department of Urology, Weill Cornell Medical College, New York Presbyterian Hospital, New York, NY, USA; Department of Urology, University of Texas Southwestern Medical Center, Dallas, TX, USA; Hourani Center for Applied Scientific Research, Al-Ahliyya Amman University, Amman, Jordan., Department of Urology, Division of Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.