文章：

评估EORTC、CUETO和EAU风险分层模型对非肌层浸润性膀胱癌卡介苗治疗后高级别复发与进展的预测准确性

Assessing the Predictive Accuracy of EORTC, CUETO and EAU Risk Stratification Models for High-Grade Recurrence and Progression after Bacillus Calmette–Guérin Therapy in Non-Muscle-Invasive Bladder Cancer

原文发布日期：26 April 2024

DOI: 10.3390/cancers16091684

类型: Article

开放获取: 是

英文摘要：

The currently available EORTC, CUETO and EAU2021 risk stratifications were originally developed to predict recurrence and progression in non-muscle-invasive bladder cancer (NMIBC). However, they have not been validated to differentiate between high-grade (HG) and low-grade (LG) recurrence-free survival (RFS), which are distinct events with specific implications. We aimed to evaluate the accuracy of available risk models and identify additional risk factors for HG RFS and PFS among NMIBC patients treated with Bacillus Calmette–Guérin (BCG). We retrospectively included 171 patients who underwent transurethral resection of the bladder tumor (TURBT), of whom 73 patients (42.7%) experienced recurrence and 29 (17%) developed progression. Initially, there were 21 low-grade and 52 high-grade recurrences. EORTC2006, EORTC2016 and CUETO recurrence scoring systems lacked accuracy in the prediction of HG RFS (C-index 0.63/0.55/0.59, respectively). EAU2021 risk stratification, EORTC2006, EORTC2016, and CUETO progression scoring systems demonstrated low to moderate accuracy (C-index 0.59/0.68/0.65/0.65) in the prediction of PFS. In the multivariable analysis, T1HG at repeat TURBT (HR = 3.17p< 0.01), tumor multiplicity (HR = 2.07p< 0.05), previous history of HG NMIBC (HR = 2.37p= 0.06) and EORTC2006 progression risk score (HR = 1.1p< 0.01) were independent predictors for HG RFS. To conclude, available risk models lack accuracy in predicting HG RFS and PFS in -NMIBC patients treated with BCG.

摘要翻译： 

目前可用的EORTC、CUETO和EAU2021风险分层模型最初是为预测非肌层浸润性膀胱癌（NMIBC）的复发和进展而开发的。然而，这些模型尚未经过验证以区分高级别（HG）和低级别（LG）无复发生存（RFS），这两者是具有特定临床意义的不同事件。本研究旨在评估现有风险模型的准确性，并确定在接受卡介苗（BCG）治疗的NMIBC患者中，影响高级别RFS和无进展生存（PFS）的其他风险因素。我们回顾性纳入了171例接受经尿道膀胱肿瘤切除术（TURBT）的患者，其中73例（42.7%）出现复发，29例（17%）发生进展。初始复发中包括21例低级别和52例高级别复发。EORTC2006、EORTC2016和CUETO复发评分系统在预测高级别RFS方面准确性不足（C指数分别为0.63、0.55和0.59）。EAU2021风险分层、EORTC2006、EORTC2016和CUETO进展评分系统在预测PFS方面表现出低至中等准确性（C指数分别为0.59、0.68、0.65和0.65）。在多变量分析中，重复TURBT时的T1HG（风险比=3.17，p<0.01）、肿瘤多发（风险比=2.07，p<0.05）、既往高级别NMIBC病史（风险比=2.37，p=0.06）以及EORTC2006进展风险评分（风险比=1.1，p<0.01）是高级别RFS的独立预测因素。总之，现有风险模型在预测接受BCG治疗的NMIBC患者的高级RFS和PFS方面缺乏准确性。

原文链接：

Assessing the Predictive Accuracy of EORTC, CUETO and EAU Risk Stratification Models for High-Grade Recurrence and Progression after Bacillus Calmette–Guérin Therapy in Non-Muscle-Invasive Bladder Cancer