Abstract：
OBJECTIVE: 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.
CONCLUSIONS: We validated the Japanese Urological Association guidelines 2019 stratification model. The revised risk model provided a more accurate treatment selection for this disease subset.
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.
CONCLUSIONS: We validated the Japanese Urological Association guidelines 2019 stratification model. The revised risk model provided a more accurate treatment selection for this disease subset.
摘要：
目的：验证日本泌尿外科协会指南2019中针对非肌层浸润性膀胱癌新定义的风险分层，并为异质中等风险组提供更准确的分层模型。
方法：共1610例患者，他接受了经尿道切除术，对9家合作医院诊断为非肌层浸润性膀胱癌的患者进行回顾性分析.他们被归类为低风险，中等风险，高风险,高危人群,和无复发生存，无进展生存期,癌症特异性生存率，比较各组的总生存率。根据复发和进展危险因素的多变量Cox回归模型，将中危组细分为两组，并创建了修订后的风险模型。
结果：无进展生存期，癌症特异性生存率，总体生存率分层，而中危组的无复发生存期在四组中最短(p<0.001)。中危组复发和无进展生存期的独立危险因素如下：年龄≥70岁，性别,多发性肿瘤,肿瘤大小≥3厘米，和复发性病例。将中危组分为两组：有利的中危组和不利的中危组。修正后的风险模型表现出显著差异。
结论：我们验证了日本泌尿外科协会指南2019分层模型。修订后的风险模型为该疾病子集提供了更准确的治疗选择。
方法：共1610例患者，
结果：无进展生存期，
结论：我们验证了日本泌尿外科协会指南2019分层模型。
