Comparison of the EORTC tables and the EAU categories for risk stratification of patients with nonmuscle-invasive bladder cancer

Abstract

Compared to EORTC risk stratification, the EAU categories reclassifies 37.9% patients into a higher risk group of recurrence and 11.8% into a higher risk of progression. However, the novel risk stratification assigns most patients to the same treatment as the more complex EORTC tables and can be regarded as an alternative tool for treatment decision-making.

The impact of frequent cystoscopy on surgical care and cancer outcomes among patients with low‐risk, non–muscle‐invasive bladder cancer

“…25,26 Frequent cystoscopic surveillance also substantially increases health care costs with only relatively small gains in quality-adjusted life-years based on a recent cost-effectiveness analysis. 8,9 Furthermore, frequent versus recommended surveillance was not associated with progression to muscle-invasive disease or bladder cancer death in our main analyses. More frequent cystoscopic surveillance likely also led to more frequent subtle lesions detected in the bladder, which then led to additional transurethral resections without cancer in the specimen.…”

“…3A), a finding that is consistent with the <5% progression rate reported by others. 8,9 Furthermore, frequent versus recommended surveillance was not associated with progression to muscle-invasive disease or bladder cancer death in our main analyses. As such, our findings support current consensus guideline recommendations for infrequent surveillance 3 and even less frequent surveillance (eg, stopping if a patient has remained recurrence-free at 1 year, as recommended by the United Kingdom's National Institute for Health and Care Excellence 28 ) might further reduce the burden on patients.…”

“…This study found no significant difference in the risk of recurrence (62% vs 50%, respectively; P = .32) or progression (7% vs 2%, respectively; P = .49), 5 but it was substantially underpowered because it included only 97 patients. [6][7][8][9] Therefore, we set out to add to the evidence base on the surveillance of low-risk NMIBC. [6][7][8][9] Therefore, we set out to add to the evidence base on the surveillance of low-risk NMIBC.…”

“…4 Recommendations are based on a single randomized trial and several Cancer September 15, 2019 observational studies. [5][6][7][8][9] The randomized trial included 97 patients with low-risk NMIBC who were assigned to more frequent surveillance (every 3 months for the first 2 years) versus less frequent surveillance (every 6 months for 1 year, then annually). This study found no significant difference in the risk of recurrence (62% vs 50%, respectively; P = .32) or progression (7% vs 2%, respectively; P = .49), 5 but it was substantially underpowered because it included only 97 patients.…”

“…The observational studies did not specifically compare more frequent versus less frequent cystoscopic surveillance but, rather, indicated that about one-quarter of all patients with low-risk NMIBC may experience a recurrence at 5 years and that cancer progression is rare (<15% at 5 years). [6][7][8][9] Therefore, we set out to add to the evidence base on the surveillance of low-risk NMIBC. By using real-world data from the Department of Veterans Affairs (VA), we assessed associations between surveillance frequency (guideline-recommended vs more frequent surveillance) and outcomes.…”