World journal of urology · 2026
Multi-institutional external validation of the European risk classification for high-grade Ta non-muscle-invasive bladder cancer.
СтатьяМногоцентровое исследованиеВалидационное исследованиеНазвание и аннотация: Перевод в очереди
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Cournède Manon, Gabriel Pierre-Etienne, Lottin Marine, Moschini Marco, Soria Francesco, D'Andrea David, Shariat Shahrokh F, Budowski Alexandra, Poyet Cédric, Roumiguie Mathieu, Alvarez-Maestro Mario, Briganti Alberto, Krajewski Wojciech, Hendricksen Kees, Veerman Hans, Afferi Luca, Mattei Agostino, Di Bona Carlo, Zamboni Stefania, Simeone Claudio, Thenault Ronan, Verhoest Gregory, Gontero Paolo, Xylinas Evanguelos
Аннотация
PURPOSE: Non-muscle-invasive bladder cancer (NMIBC) is a heterogeneous disease, with Ta tumors accounting for about 70% of cases. Prognosis varies widely, especially among high-grade (HG) tumors, and current predictive systems remain imperfect. This study aimed to provide an external validation of the EAU 2021 classification for Ta HG tumors.
METHODS: A retrospective European multicenter study was conducted in 316 TaHG NMIBC. According to the presence or absence of risk factors (age > 70 years, multifocality, tumor size > 3 cm), we categorized TaHG between intermediate-risk (IR) and high-risk (HR) NMIBC. Oncological outcomes included overall and HG recurrence-free survival (RFS), progression free-survival (PFS), cystectomy free-survival (CFS), cancer specific survival (CSS) and overall survival (OS). Uni- and multivariable Cox regression analyses were used to identify the independent predictors of disease recurrence and progression.
RESULTS: Overall, 197 (62%) and 119 (38%) patients had IR and HR HG Ta NMIBC, respectively. All patients received endovesical instillations (BCG or chemotherapy). After a median follow-up of 36.0 [32.0; 42.0] months, IR was significantly associated with a higher 3-yr overall RFS (78.6% vs. 66.5%; p = 0.01), 3-yr HG RFS (79.9% vs. 69.2%; p = 0.03) and 3-yr PFS (97.2% vs. 91.5%; p = 0.02). CFS, CSS and OS were similar between IR and HR (all p > 0.05). Multivariable Cox regression analysis confirmed that HR vs. IR group was significantly associated with overall disease recurrence (HR = 1.69; p = 0.03), HG disease recurrence; (HR = 1.58; p = 0.04) and disease progression (HR = 2.33; p = 0.05).
CONCLUSION: The European classification of TaHG NMIBC offers useful prognostic insight, especially concerning disease recurrence and progression.
METHODS: A retrospective European multicenter study was conducted in 316 TaHG NMIBC. According to the presence or absence of risk factors (age > 70 years, multifocality, tumor size > 3 cm), we categorized TaHG between intermediate-risk (IR) and high-risk (HR) NMIBC. Oncological outcomes included overall and HG recurrence-free survival (RFS), progression free-survival (PFS), cystectomy free-survival (CFS), cancer specific survival (CSS) and overall survival (OS). Uni- and multivariable Cox regression analyses were used to identify the independent predictors of disease recurrence and progression.
RESULTS: Overall, 197 (62%) and 119 (38%) patients had IR and HR HG Ta NMIBC, respectively. All patients received endovesical instillations (BCG or chemotherapy). After a median follow-up of 36.0 [32.0; 42.0] months, IR was significantly associated with a higher 3-yr overall RFS (78.6% vs. 66.5%; p = 0.01), 3-yr HG RFS (79.9% vs. 69.2%; p = 0.03) and 3-yr PFS (97.2% vs. 91.5%; p = 0.02). CFS, CSS and OS were similar between IR and HR (all p > 0.05). Multivariable Cox regression analysis confirmed that HR vs. IR group was significantly associated with overall disease recurrence (HR = 1.69; p = 0.03), HG disease recurrence; (HR = 1.58; p = 0.04) and disease progression (HR = 2.33; p = 0.05).
CONCLUSION: The European classification of TaHG NMIBC offers useful prognostic insight, especially concerning disease recurrence and progression.