OA Epidemiology

Risk Prediction Scores for Recurrence and Progression of Non-Muscle Invasive Bladder Cancer: An International Validation

Proceedings of the 2013 annual meeting of the Netherlands Epidemiology Society

Volume 1 Issue S1 Abstract 42


M.M. Vedder, Erasmus Medical Centre, Rotterdam, the Netherlands
M. Márquez, CNIO, Madrid, Spain
E.W. de Bekker-Grob, Erasmus Medical Centre, Rotterdam, the Netherlands
M.L. Calle, University of Vic, Barcelona, Spain
L. Dyrskjøt, Aarhus University Hospital, Denmark
M. Kogevinas, Municipal Institute of Medical Research, Barcelona, Spain
U. Segersten, Uppsala University, Uppsala, Sweden
P-U Malmström, Uppsala University, Uppsala, Sweden
F. Algaba, Fundación Puigvert-University Autonomous, Barcelona, Spain
W.Beukers, Erasmus Medical Center, Rotterdam, the Netherlands
T.F. Ørntoft, Aarhus University Hospital, Denmark
E. Zwarthoff, Erasmus Medical Center, Rotterdam, the Netherlands
F.X. Real, CNIO, Madrid; Universitat Pompeu Fabra, Barcelona, Spain
N. Malats, CNIO, Madrid, Spain
E.W. Steyerberg, Erasmus Medical Centre, Rotterdam, the Netherlands

Bladder cancer is a major health issue. To better target surveillance, risk scores for recurrence and progression prediction have been developed. We aimed to determine the validity of two widely used risk scores for patients with non-muscle invasive bladder cancer (NMIBC) in different European settings.

We included 1,892 patients with primary stage Ta or T1 who underwent a transurethral resection in Spain (n=973), the Netherlands (n=639), or Denmark (n=280). We evaluated recurrence-free survival and progression-free survival according to the EORTC and  the CUETO risk scores for each patient and used c-statistics to indicate discriminative ability.

The 3 cohorts were comparable according to age and sex, but patients from Denmark had a larger proportion of patients with the high stage and grade at diagnosis (p<0.01). At least one recurrence occurred in 839 (44%) patients and 258 (14%) patients had a progression during a median follow-up of 74 months. Patients from Denmark had the highest 10-year recurrence and progression rates (75% and 24%, respectively), whereas patients from Spain had the lowest rates (34% and 10%, respectively). The EORTC and  CUETO risk scores both predicted progression better than recurrence with c-statistics ranging from 0.72 to 0.82 while for recurrence, those ranged from 0.55 to 0.61.

Although this was a retrospective analysis, this study clearly exposes the limited predictive abilities of the EORTC and  CUETO risk scores for recurrence, and to a lesser extent for progression. New prognostic markers are needed to better predict recurrence of tumours in primary  NMIBC patients.

Published: 06 Jun, 2013

Licensee OA Publishing London 2013. Creative Commons Attribution License (CC-BY)