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Multicenter Study
. 2023 May;30(5):473-481.
doi: 10.1111/iju.15162. Epub 2023 Feb 14.

Validation of the risk stratification newly defined in the Japanese Urological Association guidelines 2019 for non-muscle invasive bladder cancer: A multi-institutional collaborative study

Tatsuki Miyamoto  1 , Makito Miyake  1 , Tomonori Nakahama  1 , Nobutaka Nishimura  1 , Kenta Onishi  1 , Kouta Iida  1 , Masaya Yonemori  2 , Hideki Enokida  2 , Masayuki Nakagawa  2 , Hiroaki Matsumoto  3 , Hideyasu Matsuyama  3 , Yuto Matsushita  4 , Hideaki Miyake  4 , Tomomi Fujii  5 , Keiji Shimada  6 , Satoshi Baba  7 , Mitsuru Kinjyo  8 , Tatsuro Shimokama  8 , Koji Okumura  9 , Kiyohide Fujimoto  1 ; Nishinihon Uro-oncology Extensive Collaboration group
Affiliations
Multicenter Study

Validation of the risk stratification newly defined in the Japanese Urological Association guidelines 2019 for non-muscle invasive bladder cancer: A multi-institutional collaborative study

Tatsuki Miyamoto et al. Int J Urol. 2023 May.

Abstract

Objectives: To validate the risk stratification newly defined in the Japanese Urological Association guidelines 2019 for non-muscle invasive bladder cancer and provide a more accurate stratification model for a heterogeneous intermediate-risk group.

Methods: A total of 1610 patients, who underwent transurethral resection, diagnosed with non-muscle invasive bladder cancer in nine collaborating hospitals were retrospectively reviewed. They were classified into low-risk, intermediate-risk, high-risk, and highest-risk groups, and recurrence-free survival, progression-free survival, cancer-specific survival, and overall survival were compared among the groups. The intermediate-risk group was subdivided into two groups based on the multivariable Cox regression model of recurrence and progression risk factors, and a revised risk model was created.

Results: The progression-free survival, cancer-specific survival, and overall survival were well stratified, while the recurrence-free survival of the intermediate-risk group was the shortest among the four groups (p < 0.001). The independent risk factors for recurrence and progression-free survival in the intermediate-risk group were as follows: age ≥ 70 years, sex, multiple tumors, tumor size ≥3 cm, and recurrent cases. The intermediate-risk group was subdivided into two groups: favorable intermediate-risk group and unfavorable intermediate-risk group. The revised risk model showed significant differences.

Conclusion: We validated the Japanese Urological Association guidelines 2019 stratification model. The revised risk model provided a more accurate treatment selection for this disease subset.

Keywords: European Association of Urology; Japanese Urological Association; intermediate risk; non-muscle invasive bladder cancer; risk stratification.

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References

REFERENCES

    1. Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2018;68:394-424.
    1. Woldu SL, Bagrodia A, Lotan Y. Guideline of guidelines: non-muscle invasive bladder cancer. BJU Int. 2017;119:371-80.
    1. Matsumoto H, Shiraishi K, Azuma H, Inoue K, Uemura H, Eto M, et al. Clinical practice guidelines for bladder cancer 2019 edition by the Japanese Urological Association: revision working position paper. Int J Urol. 2020;27:362-8.
    1. Matsumoto H, Shiraishi K, Azuma H, Inoue K, Uemura H, Eto M, et al. Clinical practice guidelines for bladder cancer 2019 update by the Japanese Urological Association: summary of the revision. Int J Urol. 2020;27:702-9.
    1. Kikuchi E, Fujimoto H, Mizutani Y, Okajima E, Koga H, Hinotsu S, et al. Clinical outcome of tumor recurrence for Ta, T1 non-muscle invasive bladder cancer from the data on registered bladder cancer patients in Japan: 1999-2001 report from the Japanese Urological Association. Int J Urol. 2009;16:279-86.

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