Validation of EORTC, CUETO and EAU risk stratification in prediction of recurrence, progression and death of patients with initially non-muscle invasive bladder cancer (NMIBC): a cohort analysis with systematic review.
Year: 2019
Type: preprint
Study design: Observational Study
Abstract: Purpose: To validate and summarize current evidence about the reliability of EORTC, CUETO and EAU risk stratification in prediction of recurrence, progression and death of patients with initially non-muscle-invasive bladder cancer (NMIBC).Methods: Retrospective cohort analysis of 322 patients with newly diagnosed NMIBC. We assessed the concordance (Harrell's c-index) of our results with calculated risk scores in Cox proportional hazard regression models and utilized receiver operating characteristic curve analysis (area under curve; AUCROC). Lastly, to further confirm our observations we conducted a systematic reviewResults: 1-year and 5-year c-indices ranged from 0.55 to 0.66 for recurrence and from 0.72 to 0.82 for progression. AUCROC of predictions ranged from 0.46 for 1-year recurrence risk based on CUETO groups to 0.82 for 1-year progression risk based on EAU risk groups. The accuracy of prediction was lower for patients treated with BCG maintenance immunotherapy. EORTC model (overall c-index c=0.64; 95%CI:0.61-0.68) was superior to EAU (p=0.035; 0.62; 95%CI: 0.59-0.66) and CUETO (p<0.001; c=0.53; 95%CI:0.50-0.56) model in recurrence prediction. EORTC model (c=0.82; 95%CI:0.77-0.86) also performed better than CUETO (p=0.008; c=0.73; 95%CI:0.66-0.81) but there was no sufficient evidence that it performed better than EAU (p=0.572; c=0.81; 95%CI:0.77-0.84) for predicting progression. EORTC and CUETO comparably predicted progression in BCG-treated EAU high-risk patients (p=0.48).Conclusions: The division into risk groups by EORTC, CUETO and EAU offered moderately accurate predictions about recurrence and progression of NMIBC, which emphasizes the urgent need for the development of more personalized and accurate predictive tool. EORTC provided the best recurrence and progression prediction.
Source: Research Square
Institutions: Medical University of Lodz, Dana-Farber Cancer Institute
Language: English
Subfield: Surgery
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W3213618232