Early Recurrence Following Complete Initial Resection Predicts Adverse Oncological Outcomes in NMIBC

Area of Science:

• Urology
• Oncology
• Cancer Research

Background:

• Early recurrence (ER) after transurethral resection of bladder tumor (TUR-BT) suggests aggressive non-muscle-invasive bladder cancer (NMIBC).
• Identifying predictors of ER and its impact on patient outcomes is crucial for effective management.

Purpose of the Study:

• To identify clinicopathological predictors of early recurrence (ER) in non-muscle-invasive bladder cancer (NMIBC) patients.
• To evaluate the independent impact of ER on progression-free survival (PFS), cancer-specific survival (CSS), and overall survival (OS).

Main Methods:

• Retrospective analysis of clinical data from 335 primary NMIBC patients who underwent TUR-BT.
• Logistic regression identified ER predictors; Kaplan-Meier and Cox regression analyzed survival outcomes.
• A 36-month landmark analysis was performed to adjust for follow-up duration variability.

Main Results:

• Early recurrence (ER) occurred in 35.2% of patients.
• Independent predictors of ER included larger tumor size, T1 stage, high-grade pathology, and absence of intravesical chemotherapy (IVC).
• Adjuvant IVC and intravesical BCG independently reduced ER risk. ER independently predicted worse PFS, CSS, and OS (all p < 0.001).

Conclusions:

• Early recurrence (ER) after complete transurethral resection of bladder tumor (TUR-BT) is a significant independent predictor of adverse oncological outcomes.
• Identifying high-risk patients and implementing early intravesical therapy are key strategies to potentially improve outcomes by preventing ER.