Sever Chiujdea, Bogdan Petruţ, Orsolya Martha, Ariana-Lisa Chiujdea, Daniel Porav-Hodade, Anca Ioana Răchită, Anca Sin
{"title":"Prognostic Factors of Long-Term Survival in Non-Muscle-Invasive Bladder Cancer: An 18-Year Retrospective Study from Real-Life Practice.","authors":"Sever Chiujdea, Bogdan Petruţ, Orsolya Martha, Ariana-Lisa Chiujdea, Daniel Porav-Hodade, Anca Ioana Răchită, Anca Sin","doi":"10.21614/chirurgia.3154","DOIUrl":null,"url":null,"abstract":"<p><p><b>Introduction:</b> Non-muscle-invasive bladder cancer (NMIBC) is common and heterogeneous, requiring risk-adapted therapeutic strategies. BCG remains standard for intermediate- and high-risk forms, but its effectiveness is influenced by limited access, variable tolerance, treatment resistance, and healthcare system disruptions. Material and <b>Methods:</b> This retrospective study aimed to identify prognostic factors for survival with an additional assessment of the influence of the COVID-19 pandemic. Although we could not directly evaluate the effect of COVID- 19 pandemic due to lack of recorded variables,we hypothesize it may have contributed to the limited impact of BCG therapy in our real-world setting. A total of 100 patients were selected from an initial group of 297 diagnosed in the Urology Clinic of Tg.Mures between 2006 - 2008, followed up until 2024. Prognostic analysis included clinical variables, RecScore and ProgScore were calculated using the EORTC risk calculator. No specific cut-offs were applied; the scores were analyzed as continuous variables. <b>Results:</b> Age over 70 and tumor multiplicity were significantly associated with increased mortality. RecScore was significantly correlated with the risk of relapse (p=0.0464). ProgScore showed a marginal association with mortality in univariate analysis (p=0.0561), but was not significant in multivariate models (p=0,9159). BCG therapy had a marginal protective effect, but did not significantly influence survival. Although we could not directly evaluate the effect of COVID-19 pandemic due to lack of recorded variables,we hypothesize that it may have contributed to treatment discontinuities in this real-life cohort. <b>Conclusions:</b> The results support the need for personalized, risk-based strategies and underline the importance of integrating real-world data into NMIBC management, especially in the context of systemic disruptions.</p>","PeriodicalId":10171,"journal":{"name":"Chirurgia","volume":"120 4","pages":"459-466"},"PeriodicalIF":0.8000,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Chirurgia","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.21614/chirurgia.3154","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"SURGERY","Score":null,"Total":0}
引用次数: 0
Abstract
Introduction: Non-muscle-invasive bladder cancer (NMIBC) is common and heterogeneous, requiring risk-adapted therapeutic strategies. BCG remains standard for intermediate- and high-risk forms, but its effectiveness is influenced by limited access, variable tolerance, treatment resistance, and healthcare system disruptions. Material and Methods: This retrospective study aimed to identify prognostic factors for survival with an additional assessment of the influence of the COVID-19 pandemic. Although we could not directly evaluate the effect of COVID- 19 pandemic due to lack of recorded variables,we hypothesize it may have contributed to the limited impact of BCG therapy in our real-world setting. A total of 100 patients were selected from an initial group of 297 diagnosed in the Urology Clinic of Tg.Mures between 2006 - 2008, followed up until 2024. Prognostic analysis included clinical variables, RecScore and ProgScore were calculated using the EORTC risk calculator. No specific cut-offs were applied; the scores were analyzed as continuous variables. Results: Age over 70 and tumor multiplicity were significantly associated with increased mortality. RecScore was significantly correlated with the risk of relapse (p=0.0464). ProgScore showed a marginal association with mortality in univariate analysis (p=0.0561), but was not significant in multivariate models (p=0,9159). BCG therapy had a marginal protective effect, but did not significantly influence survival. Although we could not directly evaluate the effect of COVID-19 pandemic due to lack of recorded variables,we hypothesize that it may have contributed to treatment discontinuities in this real-life cohort. Conclusions: The results support the need for personalized, risk-based strategies and underline the importance of integrating real-world data into NMIBC management, especially in the context of systemic disruptions.
期刊介绍:
Chirurgia is a bimonthly journal. In Chirurgia, original papers in the area of general surgery which neither
appeared, nor were sent for publication in other periodicals, can be published. You can send original articles,
new surgical techniques, or comprehensive general reports on surgical topics, clinical case presentations and,
depending on publication space, - reviews of some articles of general interest to surgeons from other publications.
Chirurgia is also a place for sharing information about the activity of various branches of the Romanian Society of
Surgery, information on Congresses and Symposiums organized by the Romanian Society of Surgery and
participation notes in other scientific meetings.
Letters to the editor: Letters commenting on papers published in Chirurgia are welcomed. They should contain
substantive ideas and commentaries supported by appropriate data, and should not exceed 2 pages. Please
submit these letters to the editor through our online system.