Bladder Tumor Location Matters: Trigone and Bladder Neck Involvement Predict Worse Oncological Outcomes in High-Grade...

Area of Science:

• Urology
• Oncology
• Cancer Research

Background:

• High-grade non-muscle-invasive bladder cancer (NMIBC) requires careful prognostic evaluation.
• The impact of specific tumor locations within the bladder on outcomes is not fully understood.

Purpose of the Study:

• To investigate the association between bladder tumor location (trigone/bladder neck) and oncological outcomes in high-grade NMIBC.
• To determine if trigone or bladder neck involvement is an independent prognostic factor.

Main Methods:

• Retrospective analysis of 1796 patients with high-grade NMIBC treated with TURBT and BCG.
• Propensity score matching (PSM) to control for confounders.
• External validation using the SEER database (20,249 patients).
• Survival endpoints included high-grade recurrence-free survival (HG-RFS), progression-free survival (PFS), and cancer-specific survival (CSS).

Main Results:

• Tumors located in the trigone or bladder neck were independently associated with worse HG-RFS in the primary cohort.
• PSM analysis confirmed worse PFS and HG-RFS for trigone/bladder neck tumors.
• In the SEER cohort, trigone and bladder neck tumors were linked to significantly worse CSS.

Conclusions:

• Bladder trigone or neck involvement is an independent prognostic factor for adverse oncological outcomes in high-grade NMIBC.
• These findings highlight the importance of tumor location in risk stratification.
• Further research is needed to understand mechanisms and guide treatment decisions.