非肌肉浸润性膀胱癌(NMIBC)的欧洲泌尿外科协会(EAU)预后因素风险组用于提供经尿道膀胱肿瘤电切术(TURBT)后患者治疗的建议。他们没有,然而,考虑到广泛使用的世界卫生组织(WHO)2004/2016分级分类,并基于1980年代接受治疗的患者。
使用WHO1973和2004/2016分级分类更新EAU预后因素风险组,并确定进展概率最低和最高的患者。
从EAUNMIBC指南小组成员的机构收集原发性NMIBC患者的个体患者数据。
患者接受TURBT,然后根据医生的判断进行膀胱内滴注。
将多变量Cox比例风险回归模型拟合到主要终点,进展为肌肉浸润性疾病或远处转移的时间。患者分为四个风险组:低,中介-,high,一个新的,高危人群。使用Kaplan-Meier曲线估计进展的概率。
共纳入3401例接受TURBT±膀胱内化疗的患者。从多变量分析中,肿瘤分期,世卫组织1973/2004-2016年级,伴随原位癌,肿瘤的数量,肿瘤大小,和年龄被用来形成四个风险组,5岁时进展的概率从<1%到>40%不等。局限性包括回顾性收集数据和缺乏中央病理学审查。
本研究提供了更新的EAU预后因素风险组,可用于告知患者治疗和随访。纳入世卫组织2004/2016年和1973年的分级分类,一个新的,已经确定了非常高危人群,泌尿科医师应在必要时及时评估和调整其治疗策略.
最新的欧洲泌尿外科协会非肌层浸润性膀胱癌预后因素风险组提供了一个改进的基础,为推荐患者的治疗和随访时间表。
The European Association of Urology (EAU) prognostic factor risk groups for non-muscle-invasive bladder cancer (NMIBC) are used to provide recommendations for patient treatment after transurethral resection of bladder tumor (TURBT). They do not, however, take into account the widely used World Health Organization (WHO) 2004/2016 grading classification and are based on patients treated in the 1980s.
To update EAU prognostic factor risk groups using the WHO 1973 and 2004/2016 grading classifications and identify patients with the lowest and highest probabilities of progression.
Individual patient data for primary NMIBC patients were collected from the institutions of the members of the EAU NMIBC
guidelines panel.
Patients underwent TURBT followed by intravesical instillations at the physician\'s discretion.
Multivariable Cox proportional-hazards regression models were fitted to the primary endpoint, the time to progression to muscle-invasive disease or distant metastases. Patients were divided into four risk groups: low-, intermediate-, high-, and a new, very high-risk group. The probabilities of progression were estimated using Kaplan-Meier curves.
A total of 3401 patients treated with TURBT ± intravesical chemotherapy were included. From the multivariable analyses, tumor stage, WHO 1973/2004-2016 grade, concomitant carcinoma in situ, number of tumors, tumor size, and age were used to form four risk groups for which the probability of progression at 5 yr varied from <1% to >40%. Limitations include the retrospective collection of data and the lack of central pathology review.
This study provides updated EAU prognostic factor risk groups that can be used to inform patient treatment and follow-up. Incorporating the WHO 2004/2016 and 1973 grading classifications, a new, very high-risk group has been identified for which urologists should be prompt to assess and adapt their therapeutic strategy when necessary.
The newly updated European Association of Urology prognostic factor risk groups for non-muscle-invasive bladder cancer provide an improved basis for recommending a patient\'s treatment and follow-up schedule.