Research On Clinical Risk Factors Of Non-Muscle-Invasive Bladder Cancer

Objectives:In 2006, Richard J developed a scoring system and risk tables for predicting recurrence and progression in individual patients with non-muscle-invasive bladder cancer (NMIBC). The aim of this study was to evaluate the feasibility of using EORTC risk tables in Chinese patients with bladder cancer.l And we compared the role of WHO1973 grading system and WHO2004 system in predicting the prognosis of NMIBC to estimate which grading system is better when we apply EORTC Risk Tables in our patients.Materials and Methods:Between October 2000 and July 2009,312 patients with NMIBC who underwent transurethral resection of the bladder tumor (TURBT) at our hospital were followed up. The probability of recurrence and progression at 1 year and 5 years post-operatively was calculated along with the 95% confidence intervals. We then compared our calculated probabilities and their 95% confidence intervals with the EORTC risk tables. Secondly, we compared WHO1973 grading system and WHO2004 system in predicting recurrence and progression of NMIBC by Kaplan-Meier plots to estimate which one is better in predicting prognosis of NMIBC.Results:Median patient age was 62.3 years (range,21-92 years), and the median follow-up duration was 46.9 months (range,4.8-151.2 months). The probability of recurrence at 1 year ranged from 6.5% to 40%, and the probability of progression ranged from less than 0.8% to 17%. At 5 years, the probability of recurrence ranged from 16.5% to 80%, and the probability of progression ranged from less than 1.6% to 34%. Both WHO1973 and WHO2004 grading system have a significant deviation in predicting progression of NMIBC(p=0.0274, p=0.0015,log-rank test). But for predicting recurrenc, WHO1973 grading system has a significant role(p=0.0364,log-rank test)while WHO2004 has not(p=0.1628,log-rank test).Conclusions:EORTC risk tables could predict recurrence and progression in Chinese patients with NMIBC. With these probabilities, a more individualized treatment plan and frequency of follow up may be adopted for patients with different risk levels. As to grading system in EORTC Risk Tables, The WHO1973 sysyem is better in predicting recurrence and progression of NMIBC.