Medizinische Universität Graz - Research portal
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SHR Neuro Cancer Cardio Lipid Metab Microb
Contieri, R; Martini, A; Beijert, IJ; Mertens, LS; Hentschel, AE; Bründl, J; Compérat, EM; Plass, K; Rodríguez, O; Subiela, Henríquez, JD; Hernández, V; de, la, Peña, E; Alemany, I; Turturica, D; Pisano, F; Soria, F; Čapoun, O; Bauerová, L; Pešl, M; Maxim, Bruins, H; Runneboom, W; Herdegen, S; Breyer, J; Brisuda, A; Calatrava, A; Rubio-Briones, J; Seles, M; Mannweiler, S; Bosschieter, J; Kusuma, VRM; Ashabere, D; Huebner, N; Seisen, T; Claps, F; Masson-Lecomte, A; Liedberg, F; Cohen, D; Lunelli, L; Cussenot, O; Sheikh, SE; Volanis, D; Côté, JF; Rouprêt, M; Haitel, A; Shariat, SF; Mostafid, AH; Nieuwenhuijzen, JA; Zigeuner, R; Dominguez-Escrig, JL; Hacek, J; Zlotta, AR; Burger, M; Evert, M; de, Kaa, CAH; van, der, Heijden, AG; Kiemeney, LALM; Soukup, V; Molinaro, L; Hurle, R; Paciotti, M; Moschini, M; Pradere, B; Perdonà, S; Gontero, P; Llorente, C; Algaba, F; Palou, J; N'Dow, J; Ribal, MJ; van, der, Kwast, TH; Babjuk, M; Sylvester, RJ; van, Rhijn, BWG.
Towards Defining Follow-up Strategies for Patients with Primary Intermediate-risk Non-muscle-invasive Bladder Cancer.
Eur Urol Oncol. 2025;
Doi: 10.1016/j.euo.2025.04.010
PubMed
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- Co-authors Med Uni Graz
- Mannweiler Sebastian
- Seles Maximilian
- Zigeuner Richard
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- Abstract:
- BACKGROUND AND OBJECTIVE: The current European Association of Urology (EAU) guidelines on non-muscle-invasive bladder cancer (NMIBC) categorize patients into four risk groups. In 2024, a specific follow-up schedule was introduced for intermediate-risk (IR) disease. However, recommendations are based on expert opinion and restricted to patients with IR-NMIBC who have primary low-grade or high-grade/grade 2 disease. Our aim was to identify a subgroup of patients with IR-NMIBC who may require more stringent follow-up. METHODS: We conducted a retrospective analysis of 2086 patients with IR-NMIBC classified according to the World Health Organization 1973 grading scheme. Multivariable Cox-regression models were fitted to identify predictors of recurrence, which were then used to dichotomize groups with low risk of recurrence (IR-Low) versus high risk of recurrence (IR-High). Kaplan-Meier curves were plotted to estimate recurrence-free survival (RFS) and progression-free survival (PFS). Smoothed hazard estimates of first recurrence were plotted by risk group. KEY FINDINGS AND LIMITATIONS: Multifocality and tumor size ≥3 cm were significantly associated with higher risk of first recurrence and were used to define the IR-High and IR-Low (unifocal, size <3 cm; n = 1087) groups. The 3-yr RFS rate was significantly worse for the IR-High group (51%, 95% confidence interval [CI] 48-54%) than for IR-Low (68%, 95% CI 65-71%). The risk of progression was low (5-yr PFS rate 96%) with no significant difference between the IR-High and IR-Low groups. CONCLUSIONS AND CLINICAL IMPLICATIONS: During IR-NMIBC follow-up for recurrence, tumor size and focality should be considered rather than grade. If the primary objective is to ensure prompt detection of recurrence, follow-up schedules should be tailored according to the risk of recurrence, with more stringent protocols for patients with IR-NMIBC at higher risk of recurrence.