EORTC Risk Model to Predict Progression in Patients With Non–Muscle-Invasive Bladder Cancer: Is It Safe to Use in Clinical Practice?

Júnior, Wilson F.S. Busato; Almeida, Gilberto Laurino; Ribas, Carmen Austrália Paredes Marcondes; Filho, Jurandir Marcondes Ribas; Cobelli, Ottavio De

doi:10.1016/j.clgc.2015.09.005

Cited by 21 publications

(14 citation statements)

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“…Some scholars report that EORTC risk tables are useful for predicting progression of NMIBC and it is essential to update new risk markers to improve risk classification and prediction of progression. [ 18 ] Nevertheless, the Chinese Urological Association guidelines choose AUA risk stratification to manage NMIBC patients. Hence, our study aimed to determine which of these methods is better for Chinese patients with NMIBC.…”

Section: Discussionmentioning

confidence: 99%

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EORTC risk tables are more suitable for Chinese patients with nonmuscle-invasive bladder cancer than AUA risk stratification

Wang

Ding²,

Jiang³

et al. 2018

Medicine

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Background:Patients with non-muscle-invasive bladder cancer (NMIBC) need accurate estimations of the risk of recurrence and progression. Physicians can offer individualized therapy after identifying high-risk tumors. In our study, we compared the applicability of European Organization for Research and Treatment of Cancer (EORTC) risk tables and American Urological Association (AUA) risk stratification in Chinese patients with NMIBC.Methods:We retrospectively studied 301 patients with NMIBC who underwent transurethral resection of bladder tumor (TURBT) between October 2000 and July 2009 at Huashan Hospital of Fudan University and analyzed their parameters. The recurrence and progression rates at 1 and 5 years postoperatively were calculated along with 95% confidence intervals. We compared them with results obtained from the EORTC risk tables and AUA risk stratification. P values <.05 were considered statistically significant.Results:The median patient age was 67 years (21–92 years) and the median follow-up duration was 46 months (2–151 months). We used EORTC risk tables to classify patients into 3 groups, depending on whether they suffered recurrence or progression after TURBT. Kaplan–Meier curves showed significant differences among the 3 recurrence-free survival (RFS) levels (P < .0001, log-rank test) and among the 3 progression-free survival (PFS) levels (P < .0001, log-rank test). AUA risk stratification showed the same results. Both classifications were suitable to predict recurrence and progression in Chinese patients. However, for high-risk patients in both series, Kaplan–Meier curves showed significant differences between RFS levels (P < .0001, log-rank test) and between PFS levels (P < .0001, log-rank test). EORTC risk tables were stricter and AUA was more sensitive in assigning patients to a high-risk group.Conclusion:EORTC risk tables are better than AUA risk stratification for predicting recurrence and progression in Chinese patients with NMIBC, especially among high-risk patients.

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Section: Discussionmentioning

confidence: 99%

“…Nonetheless, an EORTC model successfully stratified progression risks in a Brazilian cohort and was useful in predicting the progression of NMIBC. [ 22 ] In addition, our previous study showed that EORTC risk tables could predict recurrence and progression in Chinese patients with NMIBC. [ 9 ]…”

Section: Discussionmentioning

confidence: 99%

EORTC risk tables are more suitable for Chinese patients with nonmuscle-invasive bladder cancer than AUA risk stratification

Wang

Ding²,

Jiang³

et al. 2018

Medicine

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“…Well-designed registries are a good way to collect and to analyze cancer survivorship in a real-life setting, and they have an added value next to randomized controlled studies (23)(24)(25)(26)(27) EORTC and CUETO risk calculators tend to overestimate the risk of disease recurrence and progression in high-risk patients and have poor discrimination for prognostic outcomes in external validation. Recurrence and progression rates from current patients differ from those calculated from historical patient cohorts (15,16), and therefore, need to be re-determined on patient cohorts that are categorized and treated according to the current state of the art. Based on the new data generated in this registry, we will try to address this by developing a new risk calculator, which will be readily available for Flemish hospitals to use.…”

Section: Discussionmentioning

confidence: 99%

“…Because only a minority (n = 171) patients in the EORTC cohort were treated with Bacillus Calmette-Guérin (BCG) and none of them received maintenance treatment (which is now considered mandatory for at least 12 months to lead to an effect), the Spanish CUETO consortium (Club Urologico Español de Tratamiento Oncologico) developed another risk stratification model that predicts the risk of recurrence and progression based on a total of 1,062 patients treated with BCG between February 1990 and May 1999 in 4 prospective trials (14). Both risk calculators tend to overestimate the risk of disease recurrence and progression in high-risk patients and have poor discrimination for prognostic outcomes in external validation (15,16).…”

Section: Introductionmentioning

confidence: 99%

Development of a Prospective Data Registry System for Non-muscle-Invasive Bladder Cancer Patients Incorporated in the Electronic Patient File System

et al. 2019

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Purpose: To develop a prospective non-muscle-invasive bladder cancer (NMIBC) data registry by generating NMIBC-specific electronic case report forms (eCRFs) in our institution's electronic patient file system, and to report on the development and implementation of a prospective multicentric registry. Methods: Templates for data collection, including clinical outcome parameters and quality indicators, were developed in InfoPath TM as an eCRF and were incorporated in our hospital's electronic patient file system. Quality parameters for managing NMIBC patients that were identified by comprehensive literature review were included in the eCRFs. Three separate eCRFs were developed for the management of NMIBC patients: surgery report, bladder instillation form, and multidisciplinary team form. Results: In August 2013, we started a Flemish prospective clinical and pathological data registry for all patients undergoing transurethral resection of bladder tumor (TURBT) for NMIBC in four participating hospitals, three of which continued using this to date. Three more hospitals started enrolling in 2017, 2018, and 2019, respectively. Written reports of the registered clinical actions are automatically generated within the electronic medical file. When urologists complete these eCRFs, an automated ready-to-send letter to the general practitioner is generated. Up till May 2019, 2,756 TURBTs in 2,419 patients are included in the dataset. Currently, we are recruiting over 600 TURBTs every year. Conclusions: Easy-to-use eCRFs were developed and included in the electronic patient file system. This registration tool was implemented in 7 hospitals, 6 of which are still using it today. The register harvests important clinical data, while performing routine clinical practice. The data will be used to analyze real-life data of NMIBC patients, to challenge the existing guidelines, to create novel risk stratification tools, and to develop, monitor and validate quality parameters for NMIBC management.

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“…This scoring system is solely based on conventional clinical and pathological predictors of outcomes (tumor stage and grade, number of tumors, tumor size, concomitant CIS, and history of prior disease recurrence) [ 15 ]. EORTC risk tables show significant limitations and its risk classification could be improved by the updating and addition of new parameters [ 16 – 18 ]. According to a comprehensive review of the literature by Kluth et al regarding the prognostic and prediction tools in BCa, clinical utility and accuracy of such tools could be improved by biomarkers [ 17 ].…”

Section: Discussionmentioning

confidence: 99%

Multiplatform Biomarker Discovery for Bladder Cancer Recurrence Diagnosis

et al. 2016

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Purpose. Nonmuscle invasive bladder cancer (BCa) has a high recurrence rate requiring lifelong surveillance. Urinary biomarkers are promising as simple alternatives to cystoscopy for the diagnosis of recurrent bladder cancer. However, no single marker can achieve the required accuracy. The purpose of this study was to select a multiparameter panel, comprising urinary biomarkers and clinical parameters, for BCa recurrence diagnosis. Experimental Design. Candidate biomarkers were measured in urine samples of BCa patients with recurrence and BCa patients without recurrence. A multiplatform strategy was used for marker quantification comprising a multiplexed microarray and an automated platform for ELISA analysis. A multivariate statistical analysis combined the results from both platforms with the collected clinical data. Results. The best performing combination of biomarkers and clinical parameters achieved an AUC value of 0.91, showing better performance than individual parameters. This panel comprises six biomarkers (cadherin-1, IL-8, ErbB2, IL-6, EN2, and VEGF-A) and three clinical parameters (number of past recurrences, number of BCG therapies, and stage at time of diagnosis). Conclusions. The multiparameter panel could be a useful noninvasive tool for BCa surveillance and potentially impact the clinical management of this disease. Validation of results in an independent cohort is warranted.

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EORTC Risk Model to Predict Progression in Patients With Non–Muscle-Invasive Bladder Cancer: Is It Safe to Use in Clinical Practice?

Cited by 21 publications

References 21 publications

EORTC risk tables are more suitable for Chinese patients with nonmuscle-invasive bladder cancer than AUA risk stratification

EORTC risk tables are more suitable for Chinese patients with nonmuscle-invasive bladder cancer than AUA risk stratification

Development of a Prospective Data Registry System for Non-muscle-Invasive Bladder Cancer Patients Incorporated in the Electronic Patient File System

Multiplatform Biomarker Discovery for Bladder Cancer Recurrence Diagnosis

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