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Recurrence Patterns in a Large Contemporary Cohort of Patients With Non-Muscle Invasive Bladder Cancer.

Jasper P Hof1, Lambertus A L M Kiemeney2, Katja K H Aben3

  • 1IQ Health Science Department, Radboud University Medical Center, PO Box 9101, 6500GB, Nijmegen, the Netherlands.

Clinical Genitourinary Cancer
|November 27, 2025
PubMed
Summary

Subsequent non-muscle-invasive bladder cancer (NMIBC) recurrences are common and often similar to primary tumors. High-risk recurrences can precede progression to muscle-invasive bladder cancer (MIBC).

Keywords:
Observational studyOutcomeRecurring tumorsRisk stratificationUrothelial carcinoma

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Area of Science:

  • Uro-oncology
  • Cancer recurrence research
  • Bladder cancer epidemiology

Background:

  • Non-muscle-invasive bladder cancer (NMIBC) frequently recurs after initial treatment.
  • Understanding the timing and characteristics of subsequent NMIBC recurrences is crucial for effective patient management.
  • Limited data exists on the patterns and risks associated with multiple NMIBC recurrences.

Purpose of the Study:

  • To characterize the recurrence patterns and risks in a large, population-based cohort of NMIBC patients.
  • To analyze the clinicopathological features of subsequent NMIBC recurrences.
  • To identify risk factors and patterns preceding progression to muscle-invasive bladder cancer (MIBC).

Main Methods:

  • Analysis of 1915 NMIBC patients diagnosed between 2011 and 2021 from two Dutch cohorts.
  • Calculation of conditional recurrence risks (1-, 3-, 5-year) for first to fourth recurrences using Kaplan-Meier methods.
  • Stratification of recurrence risks by clinicopathological factors and visualization of tumor patterns.

Main Results:

  • Observed 671 first and 400 subsequent recurrences.
  • 3-year conditional recurrence risks increased with each subsequent recurrence (31% for first, 45% for second, 54% for third).
  • Recurring tumors often maintained similar risk classifications (low, intermediate, high); 15% of high-risk NMIBC progressions to MIBC/metastatic BC followed a high-risk recurrence.

Conclusions:

  • This study provides reliable recurrence rates and patterns for NMIBC in a contemporary, population-based setting.
  • Recurring NMIBC tumors frequently retain similar clinicopathological characteristics.
  • High-risk recurrences in NMIBC patients can precede progression to MIBC/metastatic bladder cancer, highlighting the need for vigilant surveillance.