[EORTC risk tables--a new diagnostic tool in urology]

Abstract

75-85% newly diagnosed bladder cancers are lesions that are not invading the muscle layer of bladder. Patients treated for bladder cancer in this stage are characterized that part of them will develop recurrent bladder cancer and it may progress. Depending on a patient's characteristics, after transurethral resection (TUR), the probability of recurrence at one year ranges from about 15% to 70% and the probability of progression at five years ranges from about 7% to 40%. Non-muscle invasive bladder cancer is a heterogeneous group of tumors with completely different oncological outcome. Taking into consideration the risk of recurrence and progression, many researchers attempted to define risk factors for bladder cancer. After many test and researches had been conducted in different research and development centres a few risk factors were detected such as: number of tumors, tumor size, recurrence rate, staging (7T), grading (G), presence of carcinoma in situ (CIS). Basing on those factors patients with non-muscle invasive bladder cancer were divided into three risk groups. Low risk group - single, diameter < 3 cm, TaG1 tumors, high risk group - multiple, diameter > 3 cm, frequently recurrent, T1G3 tumors with concomitant CIS, intermediate risk group - the rest of tumors not mentioned in prior two groups. When using this division into three risk groups there is no possible to predict the probability of bladder cancer recurrence and progression separately Although prognostic factors may indicate a high risk for recurrence, the risk for progression may still be low and other tumors may have a high risk of both recurrence and progression. In order to separately predict the short-term and long-term risks of both recurrence and progression in individual patients, the EORTC developed a scoring system and risk tables (EORTC nomograms).