Assessment of recurrence and progression risk in patients with non-muscle invasive bladder cancer

A retrospective analysis of monitoring of patients with primary or recurrent non-muscle invasive bladder cancer (NMIBC) treated with transurethral resection (TUR) with or without restaging TUR or intravesical therapy in State Institution N.N. Alexandrov National Cancer Centre of Belarus in 2004-2012 was performed with an objective to develop a prognostic classification for NMIBC. The analysis included 921 patients. In the multivatiate analysis independent predictors of recurrence were recurrence rate, number of tumors, tumor size, grade, and tumor location in the trigone, anterior wall, dome, and prostatic urethra; predictors of progression were age, recurrence rate, tumor size, grade, and tumor location in the trigone and prostatic urethra. The patients were divided into 4 groups with low, intermediate, high and very high risk. Corrected C-index values for the developed classifications of recurrence and progression risks were 0.635 and 0.740 respectively, which were significantly higher than C-indices for the European Organization for Research and Treatment of Cancer tables.