Predicting Nonmuscle Invasive Bladder Cancer Recurrence and Progression in Patients Treated With Bacillus Calmette-Guerin: The CUETO Scoring Model

Fernandez-Gomez, Jesus; Madero, Rosário; Solsona, E.; Unda, Miguel; Martínez‐Piñeiro, Luis; Gonzalez, M. S.; Portillo, J.A.; Ojea, A; Pertusa, C; Rodríguez‐Molina, Jesús; Camacho, José Emilio; Rabadán, M; Astobieta, Ander; Montesinos, M.; Isorna, Santiago; Muntañola, Pedro; Gimeno, A.; Blas, Miguel; Martínez-Piñeiro, J A

doi:10.1016/j.juro.2009.07.016

Cited by 502 publications

(390 citation statements)

References 19 publications

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“…3 In 2011, Rosevear et al validated the CUETO tables for recurrence in their series of 718 patients treated with BCG plus interferon α-2B. 4 In the present study, the CUETO system has been shown to be appropriate for predicting tumor recurrence and progression for patients with BCG instillation therapy in a Japanese cohort.…”

Section: Conflict Of Interestmentioning

confidence: 54%

External validation of European Organization for Research and Treatment of Cancer and Spanish Urological Club for Oncological Treatment scoring models to predict recurrence and progression in Japanese patients with non‐muscle invasive bladder cancer treated with bacillus Calmette–Guérin

et al. 2014

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Abbreviations & AcronymsObjective: To validate two prediction models (European Organization for Research and Treatment of Cancer and Spanish Urological Club for Oncological Treatment) for recurrence and progression of non-muscle invasive bladder cancer in Japanese patients who underwent bacillus Calmette-Guérin instillation therapy. Methods: From March 1985 to April 2007, data were analyzed from 366 patients who underwent transurethral resection of bladder tumor followed by bacillus Calmette-Guérin instillation therapy. The ability of two scoring models to predict recurrence and progression was assessed by concordance index. Results: For recurrence probability, the concordance index of the European Organization for Research and Treatment of Cancer and Spanish Urological Club for Oncological Treatment models was 0.514 and 0.576, respectively, which was lower than that (0.604) of a selected single prognostic factor (age) by our multivariate analysis. For progression probability, the concordance index of European Organization for Research and Treatment of Cancer and Spanish Urological Club for Oncological Treatment models was 0.693 and 0.764, respectively, which was higher than that (0.633) of a selected single factor (T stage) by our multivariate analysis. The Spanish Urological Club for Oncological Treatment scoring system resulted in better stratification of tumor recurrence and progression when compared with the European Organization for Research and Treatment of Cancer model, probably because more patients underwent bacillus Calmette-Guérin treatment in the Spanish Urological Club for Oncological Treatment cohort than in the European Organization for Research and Treatment of Cancer cohort. Conclusions: The Spanish Urological Club for Oncological Treatment scoring system is a good predictor of tumor recurrence and progression in Japanese patients who underwent bacillus Calmette-Guérin immunotherapy. A large prospective study is warranted to confirm the efficacy of this system.

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Section: Conflict Of Interestmentioning

confidence: 54%

External validation of European Organization for Research and Treatment of Cancer and Spanish Urological Club for Oncological Treatment scoring models to predict recurrence and progression in Japanese patients with non‐muscle invasive bladder cancer treated with bacillus Calmette–Guérin

et al. 2014

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“…9 The sources of recurrence are implantation during TUR, persisting CIS, and preclinical lesions. 3,10,11 In high-risk NMIBC, intravesical BCG is indicated.…”

Section: Discussionmentioning

confidence: 99%

Intravesical bacillus Calmette-Guérin versus chemohyperthermia for high-risk non-muscle-invasive bladder cancer

Ekin¹,

Akarken

Zorlu³

et al. 2015

CUAJ

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Introduction: Patients with high-risk non-muscle invasive bladder cancer (NMIBC) need adjuvant intravesical treatment after surgery. Although bacillus Calmette-Guérin (BCG) is highly effective, new adjuvant treatments to decrease recurrences and toxicity have been studies. We performed a retrospective propensity score-matched study to compare the efficacy of BCG and chemohyperthermia (C-HT). Methods: We included 1937 patients diagnosed with bladder cancer between January 2004 and January 2014. The primary efficacy endpoint was recurrence-free interval. Patients treated with C-HT were matched with patients treated with BCG using propensity score-matched analysis. Cox-regression models were used to estimate the association between intravesical treatments and the presence of recurrence and progression. Results: Of the 710 patients treated with intravesical treatments, 40 and 142 were eligible for inclusion in C-HT and BCG groups, respectively. Following case matching, there were no differences in patient or tumour characteristics between treatment groups. The 2-year recurrence-free interval in C-HT and BCG groups were 76.2% and 93.9%, respectively (p = 0.020). C-HT treatment (hazard ratio [HR] 5.42; 95% confidence interval [CI] 1.11-26.43; p = 0.036) and high-grade tumour (HR 4.60; 95% CI 1.01-20.88; p = 0.048) are associated with an elevated odds of tumour recurrence. In multivariate Cox-regression analysis, there was no significant difference between C-HT and BCG in the odds of recurrence (p = 0.054). There were no differences in progression between C-HT and BCG. Conclusion: C-HT is not as effective treatment as BCG in high-risk NMIBC patients who are BCG-naive. Although, there were no significant difference in the odds of recurrence, recurrence-free interval is significantly improved by the administration of BCG.

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“…Progression was defined as muscular invasion or metastatic disease. The clinical and pathological progression risk was calculated using two multivariate risk assessment tools, the European Organization for Research and Treatment of Cancer (EORTC) risk tables and the Spanish Urological Club for Oncological Treatment (CUETO) prognostic scoring model (13,14).…”

Section: Methodsmentioning

confidence: 99%

“…Furthermore, a significant concordance between pathological aggressive phenotype and molecular progression risk score was observed, and patients with aggressive bladder tumors exhibited increased molecular progression risk scores. Notably, the molecular progression risk score was significantly associated with clinicopathological multivariate progression models, including the EORTC and CUETO risk tables (13,14). Thus, a molecular progression risk score based on gene expression may represent biological aggressiveness, even in the absence of clinical information.…”

Section: Multivariate Analysis As Amentioning

confidence: 99%

“…Clinical risk factors for progression include: Invasion of the lamina propria, high grade based on the World Health Organization/International Society of Urologic Pathology consensus classification (8,9), tumor size, occurrence of carcinoma in situ (CIS) and multiplicity or recurrence of high-risk tumors (10)(11)(12). Two multivariate risk assessment tools for predicting the outcome of NMIBC have been developed (13,14). However, currently none of the predictive tools based on conventional clinical and pathological parameters are sufficiently sensitive or specific to detect, monitor and determine the prognosis of BC (15).…”

Section: Introductionmentioning

confidence: 99%

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Long-term validation of a molecular progression-associated gene classifier for prediction of muscle invasion in primary non-muscle-invasive bladder cancer

et al. 2017

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Abstract. Our previous study reported a clinically applicable prognostic gene classifier for primary non-muscle-invasive bladder cancer (NMIBC). The present study aimed to perform long-term validation of this classifier in the prediction of muscle-invasive disease. Previously published gene expression profiles were used from 176 patients with NMIBC with extended follow-up. Progression was defined as development of muscle invasion or metastasis, and the progression risk score was calculated using the previously developed eight-gene progression classifier. During median follow-up of 72.8 (interquartile range, 37.0-118.7) months, 26 (14.8%) patients progressed to muscle-invasive bladder cancer. The molecular progression risk score was significantly associated with clinicopathological variables, including tumor number, stage, grade and multivariate risk assessment tools (P<0.05 in each case). Multivariate Cox regression analysis revealed that molecular progression risk score was an independent predictor of development of invasive tumor, either as a continuous variable [hazard ratio (HR), 1.489; 95% confidence interval (CI), 1.216-1.823; P<0.001] or as a categorical variable (HR, 5.026; 95% CI, P= 0.005). In conclusion, the present results confirmed the clinical utility of the progression-associated gene classifier for prediction of development of muscle invasion in NMIBC. The molecular progression risk score may aid in selecting patients who could benefit from more aggressive therapeutic intervention.

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Predicting Nonmuscle Invasive Bladder Cancer Recurrence and Progression in Patients Treated With Bacillus Calmette-Guerin: The CUETO Scoring Model

Abstract: We propose a scoring model to stratify the risk of recurrence and progression in patients treated with bacillus Calmette-Guerin.

Cited by 502 publications

References 19 publications

External validation of European Organization for Research and Treatment of Cancer and Spanish Urological Club for Oncological Treatment scoring models to predict recurrence and progression in Japanese patients with non‐muscle invasive bladder cancer treated with bacillus Calmette–Guérin

External validation of European Organization for Research and Treatment of Cancer and Spanish Urological Club for Oncological Treatment scoring models to predict recurrence and progression in Japanese patients with non‐muscle invasive bladder cancer treated with bacillus Calmette–Guérin

Intravesical bacillus Calmette-Guérin versus chemohyperthermia for high-risk non-muscle-invasive bladder cancer

Long-term validation of a molecular progression-associated gene classifier for prediction of muscle invasion in primary non-muscle-invasive bladder cancer

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