Influencing Factors And The Judgment Of The Prognosis Of Non-muscle Invasive Urothelial Bladder Cancer

Objective: To explore the main influencing factors and clinicalsignificance of recurrence and progression of non-muscle-invasive bladdercancer.Methods: Clinical data of174patients with non-muscle invasive bladdercancer patients treated in our hospital from January2008to June2011wereanalyzed by the methods of retrospective analysis. Methods of Kaplan-Meierand Log-rank test were used to assess the influencing degree of clinical andpathological features (single factor) on the tumor recurrence and progressionrisks. Multivariate survival analysis of Cox proportional hazards regressionmodel was done to analysis the significant variables of univariate analysis tothe recurrence and progression of diseases.Result: Patients age, tumor number, tumor stage, tumor grade, tumorlocation, postoperative immediate perfusion and past recurrence showed byunivariate analysis were significantly associated with the tumor recurrence (P＜0.05). Tumor diameter, tumor stage, tumor grade, postoperative immediateperfusion and past recurrence condition were significantly with the tumorprogression (P＜0.05). Relative risks of tumor recurrence were drawn fromthe above mentioned factors included into the COX risk model. Relative risksof every factor were as follows: tumor stage（RR=2.041,P=0.046）, tumorgrade（RR=1.548,P=0.037）, postoperative immediate perfusion（RR=2.335,P=0.005）, past recurrence（RR=1.484,P=0.048）. Risk factors of every factor on tumor progression are as follows: tumor grade（RR=3.019,P=0.006）,tumor diameter（RR=5.062,P=0.005）, past recurrence（RR=2.345,P=0.012）.Conclusions: Tumor stage、 tumor grade、postoperative immediateperfusion and past recurrence were closely associated with the recurrence ofnon-muscle invasive bladder cancer. However, tumor diameter、tumor gradeand past recurrence were greatly influenced to the tumor progression. Objective: The important clinical and pathological factors thatinfluencing the prognosis of non-muscle invasive bladder urothelial cancerwere summarized. European organization of research and treatment of cancer(EORTC) risk tables was used to evaluate the factors, to explore thefeasibility of EORTC risk tables in the evaluation of the prognosis ofnon-muscle invasive bladder urothelial cancer in our country and to evaluatetheir value in the evaluation of prognosis.Methods: Clinical data of174patients with non-muscle invasive bladdercancer treated in our hospital from January2008to June2011were analyzedby the methods of retrospective analysis. The tumor recurrence andprogression of every patient were scored according to EORTC risk tablessystem. Patients were divided into several groups based on different totalscores. Rates of one-year recurrence and progression were calculatedaccording to the actual situation of the patients, compared with the reference value of EORTC risk tables system. Chi-square test was used to compare thedifferences between the actual recurrence rate、progression rate with thepredicted value, and to compare whether there is difference among each groupof the low, medium and high.Result:49cases (28.16%) of174patients were with tumor recurrencewithin one year, and8patients (4.6%) were with tumor progression.174patients were divided into0score group,1-4score group,5-9score group and10-17score group according to the actual situation of patients. One-yearrecurrence rates of every group were as follows:16.67%（7/42）、22.58%（14/62）、31.91%（15/47）and56.62%（13/23）, respectively. One-yearprogression rates of0-1score group、2-6score group、7-13score group and14-23score group were0（0/46）、1.69%（1/59）、4%（2/50）and26.32%（5/19）. Compared with EORTC risk tables, there was no significantdifference between the real rates and the estimated rates of the EORTC risktables (P＞0.05). However, there was significant difference of recurrence andprogression rates of one year among the low risk group, medium group andhigh risk group (P<0.05).Conclusions: Short-term prognosis of non-muscle invasive bladdercancer was quickly and easily evaluated by EORTC risk tables. Nevertheless,whether the prediction of long-term prognosis would be widely available stillneed more research to be confirmed.