Prediction of recurrence risk in patients with non-muscle-invasive bladder cancer

IF 2.4 3区医学 Q2 UROLOGY & NEPHROLOGY

Asian Journal of Urology Pub Date : 2024-10-01 DOI:10.1016/j.ajur.2023.04.007

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引用次数: 0

Abstract

Objective

Non-muscle-invasive bladder cancer (NMIBC) remains a common challenge in uro-oncology with conflicting reports on recurrence risk. This study aimed to elucidate the recurrence rate of NMIBC in the Cancer Clinic of Shahid Beheshti Hospital in Iran and to investigate related parameters affecting recurrence risk.

Methods

The data of 143 patients with NMIBC, who underwent treatment between January 2017 and January 2020 and were followed up from the initial transurethral resection of bladder tumor until November 30, 2020 in our institution, were retrospectively assessed. The Cox regression analysis and Kaplan–Meier plot of recurrence-free survival were used to determine independent contributing factors for tumor recurrence.

Results

Among patients with NMIBC, 83.9% were male, and 16.1% were female, with a mean age of 64.4 (standard deviation [SD] 12.9) years. During the follow-up, 71 (49.7%) patients showed tumor recurrence, with a mean recurrence time of 11.5 (SD 6.9) months. In the Chi-square test or Fisher's exact test, the age (≥65 years) (p=0.037), obesity (body mass index ≥30 kg/m²) (p=0.004), no diabetes mellitus (p=0.005), smoking (current or former smoker) (p=0.001), immediate perfusion therapy (p=0.035), number of tumors (>3) (p<0.001), and tumor stage (Ta, T1, and Tis) (p=0.001) had independent significant effects on the recurrence of NMIBC. The multivariate Cox regression analysis indicated that preoperative obesity (hazards ratio [HR] 7.90; 95% confidential interval [CI] 4.01–15.55; p<0.001), current or former smoking (HR 1.85; 95% CI 1.07–3.20; p=0.027), and a high-grade tumor (HR 4.03; 95% CI 1.59–10.25; p=0.003) were significant predictors of tumor recurrence. The Kaplan–Meier plot of recurrence-free survival showed that obesity (log-rank p<0.001), current or former smoking (log-rank p=0.001), and a high-grade tumor (log-rank p=0.006) were associated with a shorter time interval until the first tumor recurrence.

Conclusion

The study found a high recurrence rate of NMIBC in Iran from January 2017 to January 2020, with the obesity, smoking history, and the high-grade tumor as contributing factors.

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预测非肌层浸润性膀胱癌患者的复发风险

目的非肌层浸润性膀胱癌（NMIBC）仍然是泌尿肿瘤学中的一个常见难题，有关其复发风险的报道相互矛盾。本研究旨在阐明伊朗沙希德-贝赫什提医院癌症诊所的非肌层浸润性膀胱癌复发率，并调查影响复发风险的相关参数。方法回顾性评估了我院在 2017 年 1 月至 2020 年 1 月期间接受治疗的 143 例非肌层浸润性膀胱癌患者的数据，这些患者从最初的经尿道膀胱肿瘤切除术开始随访，直至 2020 年 11 月 30 日。结果在NMIBC患者中，83.9%为男性，16.1%为女性，平均年龄为64.4（标准差[SD]12.9）岁。随访期间，71 例（49.7%）患者肿瘤复发，平均复发时间为 11.5 个月（标准差 6.9 个月）。在卡方检验或费雪精确检验中，年龄（≥65 岁）（P=0.037）、肥胖（体重指数≥30 kg/m2）（P=0.004）、无糖尿病（P=0.005）、吸烟（目前或曾经吸烟）（P=0.001）、立即灌注治疗（p=0.035）、肿瘤数目（>3）（p<0.001）和肿瘤分期（Ta、T1和Tis）（p=0.001）对NMIBC的复发有独立的显著影响。多变量 Cox 回归分析表明，术前肥胖（危险比 [HR] 7.90；95% 置信区间 [CI]4.01-15.55；p<0.001）、目前或曾经吸烟（HR 1.85；95% CI 1.07-3.20；p=0.027）和高级别肿瘤（HR 4.03；95% CI 1.59-10.25；p=0.003）是肿瘤复发的重要预测因素。无复发生存期的卡普兰-梅耶尔图显示，肥胖（对数秩p<0.001）、目前或曾经吸烟（对数秩p=0.001）和高级别肿瘤（对数秩p=0.006）与肿瘤首次复发前的时间间隔较短有关。结论该研究发现，从2017年1月至2020年1月，伊朗的NMIBC复发率较高，肥胖、吸烟史和高级别肿瘤是诱因。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Asian Journal of Urology UROLOGY & NEPHROLOGY-

CiteScore

4.00

自引率

3.80%

发文量

100

审稿时长

4 weeks

期刊介绍： Asian Journal of Urology (AJUR), launched in October 2014, is an international peer-reviewed Open Access journal jointly founded by Shanghai Association for Science and Technology (SAST) and Second Military Medical University (SMMU). AJUR aims to build a communication platform for international researchers to effectively share scholarly achievements. It focuses on all specialties of urology both scientifically and clinically, with article types widely covering editorials, opinions, perspectives, reviews and mini-reviews, original articles, cases reports, rapid communications, and letters, etc. Fields of particular interest to the journal including, but not limited to: • Surgical oncology • Endourology • Calculi • Female urology • Erectile dysfunction • Infertility • Pediatric urology • Renal transplantation • Reconstructive surgery • Radiology • Pathology • Neurourology.