Exploration of risk factors predicting outcomes for primary T1 high-grade bladder cancer and validation of the Spanish Urological Club for Oncological Treatment scoring model: Long-term follow-up experience at a single institute

• Published in: International journal of urology 2015-06, Vol.22 (6), p.541-547
• Main Authors: Miyake, Makito, Gotoh, Daisuke, Shimada, Keiji, Tatsumi, Yoshihiro, Nakai, Yasushi, Anai, Satoshi, Torimoto, Kazumasa, Aoki, Katsuya, Tanaka, Nobumichi, Konishi, Noboru, Fujimoto, Kiyohide
• Format: Article
• Language: English
• Subjects: Aged; bladder cancer; broad base; Carcinoma, Transitional Cell - pathology; Carcinoma, Transitional Cell - surgery; Disease Progression; Disease-Free Survival; Female; Follow-Up Studies; high grade; Humans; infiltrative pattern; Japan; Male; Middle Aged; Neoplasm Grading; Neoplasm Invasiveness; Neoplasm Recurrence, Local - pathology; Retrospective Studies; Risk Assessment - methods; Risk Factors; Spanish Urological Club for Oncological Treatment scoring model; Survival Rate; Time Factors; Urinary Bladder Neoplasms - pathology; Urinary Bladder Neoplasms - surgery
• ISSN: 0919-8172; 1442-2042
• DOI: 10.1111/iju.12749

Objective To determine the prognostic factors of primary T1 high‐grade bladder cancer and to validate the Spanish Urological Club for Oncological Treatment model in Japanese patients with T1 high‐grade bladder cancer treated at a single institution. Methods Records of 106 patients with T1 high‐grade bladder cancer treated from 1998 to 2013 were retrospectively reviewed. Variables included various clinicopathological parameters, including lymphovascular invasion and tumor growth pattern at the invasion front. Recurrence‐free survival and progression‐free survival were analyzed. Multivariate Cox proportional regression analysis was used to verify the prognostic significance of the variables. Scores for recurrence and progression were calculated using the Spanish Urological Club for Oncological Treatment model. Results Of 106 patients, 44 (42%) had recurrence and 16 (15%) developed progression after a median (interquartile range) follow‐up period of 54 months (range 32–81 months). Non‐papillary shape was the only independent predictor for recurrence, while broad‐based tumor stalk and infiltrative tumor growth pattern at the invasion front were determined to be independent predictors for progression. Stratification of patients according to the number of progression risk factors yielded hazard ratios of 10.1 and 13.1 in patients having one and two risks, respectively, compared with those without any risks. The Spanish Urological Club for Oncological Treatment model successfully stratified our patients with a trend toward different probabilities of recurrence and progression. Conclusions The results of the present study might be helpful for counseling certain patients towards intensive treatment, such as radical cystectomy and/or platinum‐based systemic chemotherapy. In addition, the Spanish Urological Club for Oncological Treatment model might be applicable to Japanese patients with T1 high‐grade bladder cancer.