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Bladder tumor Resection Weight as a Prognostic Factor for Recurrence and Progression in Patients With High-Risk
Oliver C Hald1, Yih Chyn Phan2, Charles J M Carter3
1Department of Urology, Royal Bournemouth Hospital, University Hospitals Dorset NHS Foundation Trust, Castle Lane East, Bournemouth, UK; Urology Centre, Guy's Hospital, Guys and St Thomas' NHS Foundation Trust, Great Maze Pond, London, UK.
Bladder tumor resection weight predicts recurrence and progression in high-risk non-muscle invasive bladder cancer (HR-NMIBC) patients treated with Bacillus Calmette-Guérin (BCG). Higher resection weights are linked to increased disease recurrence and progression, improving prognostic models.
Area of Science:
- Urology
- Oncology
- Cancer Research
Background:
- Predicting outcomes for high-risk non-muscle invasive bladder cancer (HR-NMIBC) is crucial for effective patient management.
- Bacillus Calmette-Guérin (BCG) immunotherapy is a standard treatment for HR-NMIBC.
Purpose of the Study:
- To evaluate bladder tumor resection weight as a prognostic factor for recurrence and progression in HR-NMIBC patients undergoing BCG treatment.
- To determine if resection weight can enhance existing prognostic models.
Main Methods:
- Retrospective, single-center study of 187 HR-NMIBC patients treated with intravesical BCG (2009-2019).
- Univariable and multivariable Cox proportional hazards models were used to assess the association of resection weight with recurrence and progression.
- Established predictors were analyzed alongside resection weight.
Main Results:
- Increased bladder tumor resection weight was significantly associated with higher risks of both recurrence (P=.007) and progression (P=.019).
- Resection weights ≥2g and ≥3g conferred substantially increased risks of recurrence (4.35-fold) and progression (9.03-fold), respectively (P<.001).
- Incorporating resection weight improved the predictive accuracy of standard prognostic models by 3.8% for recurrence and 4.3% for progression.
Conclusions:
- Bladder tumor resection weight is a significant prognostic factor for disease recurrence and progression in HR-NMIBC patients treated with BCG.
- The addition of resection weight measurement improves the discrimination of established prognostic models.
- Resection weight may be considered for routine clinical practice to better stratify HR-NMIBC patient risk.
