{Reference Type}: Journal Article
{Title}: 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.
{Author}: Miyamoto T;Miyake M;Nakahama T;Nishimura N;Onishi K;Iida K;Yonemori M;Enokida H;Nakagawa M;Matsumoto H;Matsuyama H;Matsushita Y;Miyake H;Fujii T;Shimada K;Baba S;Kinjyo M;Shimokama T;Okumura K;Fujimoto K; ;
{Journal}: Int J Urol
{Volume}: 30
{Issue}: 5
{Year}: May 2023 14
{Factor}: 2.896
{DOI}: 10.1111/iju.15162
{Abstract}: <B>OBJECTIVE: </B>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.<BR><B>METHODS: </B>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.<BR><B>RESULTS: </B>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.<BR><B>CONCLUSIONS: </B>We validated the Japanese Urological Association guidelines 2019 stratification model. The revised risk model provided a more accurate treatment selection for this disease subset.