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Risk-based Management of Non-muscle Invasive Bladder Cancer: Experience from Tribhuvan University Teaching Hospital.

B R Luitel1, P R Chalise1, S Nathani1

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Summary
This summary is machine-generated.

Risk-based management for non-muscle invasive bladder cancer (NMIBC) using European Organization for Research and Treatment of Cancer (EORTC) risk tables is effective. Intravesical Bacillus Calmette Guerin (BCG) therapy significantly reduced recurrence rates in high-risk NMIBC patients.

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Area of Science:

  • Urology
  • Oncology
  • Clinical Research

Background:

  • Non-muscle invasive bladder cancer (NMIBC) management increasingly relies on risk stratification.
  • European Organization for Research and Treatment of Cancer (EORTC) risk tables are standard tools for predicting NMIBC recurrence and progression.
  • Assessing the utility of these risk tables in diverse populations is crucial for refining treatment strategies.

Purpose of the Study:

  • To evaluate the recurrence and progression rates of NMIBC in Nepalese patients.
  • To validate the predictive accuracy of the EORTC risk tables for this patient cohort.
  • To assess the effectiveness of intravesical therapies, particularly Bacillus Calmette Guerin (BCG), in reducing NMIBC recurrence.

Main Methods:

  • A prospective observational study was conducted at a single center involving 46 NMIBC patients.
  • Patients were stratified into low, intermediate, and high-risk groups using EORTC risk tables.
  • Follow-up data over two years were collected, and adjuvant therapies were administered according to European Association of Urology guidelines.

Main Results:

  • The overall two-year recurrence and progression rates were 17% and 2%, respectively.
  • No recurrence or progression was observed in the low-risk group (n=7).
  • Recurrence rates in intermediate (n=15) and high-risk (n=24) groups were 20% and 21% at two years, respectively, with intravesical BCG showing a 58-60% risk reduction in high-risk patients.

Conclusions:

  • Risk-based management using EORTC tables is a valuable approach for NMIBC.
  • The EORTC risk tables demonstrated lower predictive accuracy in the Nepalese population compared to established data.
  • Intravesical BCG therapy proved effective in reducing recurrence risk, especially in high-risk NMIBC patients.