Non-Muscle Invasive Bladder Cancer: Difference between revisions
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*** '''Recurrence: prior recurrence rate, number of tumours, tumour size''' | *** '''Recurrence: prior recurrence rate, number of tumours, tumour size''' | ||
*** '''Progression: T-stage, grade, presence of CIS''' | *** '''Progression: T-stage, grade, presence of CIS''' | ||
** Probability of recurrence and progression of NMIBC can be calculated based on these 6 factors with | ** Probability of recurrence and progression of NMIBC can be calculated based on these 6 factors with the [http://www.eortc.be/tools/bladdercalculator/ European Organization for Research and Treatment of Cancer (EORTC) risk tables]. | ||
*** These tables were developed and based on individual patient data from 2596 patients diagnosed with Ta/T1 tumours who were randomized in 7 EORTC trials. | *** These tables were developed and based on individual patient data from 2596 patients diagnosed with Ta/T1 tumours who were randomized in 7 EORTC trials. | ||
*** Note that the EORTC risk calculator likely overestimates the risk of recurrence and progression, as very few of the patients in these prospective trials received intravesical BCG | *** Note that the EORTC risk calculator likely overestimates the risk of recurrence and progression, as very few of the patients in these prospective trials received intravesical BCG | ||
* '''<span style="color:#ff0000">Other risk factors</span>''' | * '''<span style="color:#ff0000">Other risk factors</span>''' | ||
** '''Mentioned in 2021 CUA NMIBC Guidelines (5):''' | ** '''Mentioned in [https://pubmed.ncbi.nlm.nih.gov/33938798/ 2021 CUA NMIBC Guidelines] (5):''' | ||
**# '''<span style="color:#ff0000">Age > 70 yr</span>''' | **# '''<span style="color:#ff0000">Age > 70 yr</span>''' | ||
**# '''<span style="color:#ff0000">Extensive invasion of the lamina propria</span>''' | **# '''<span style="color:#ff0000">Extensive invasion of the lamina propria</span>''' | ||
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**#* '''Retrospective studies demonstrate that the presence of LVI is an independent factor for progression in patients with high-risk NMIBC'''. | **#* '''Retrospective studies demonstrate that the presence of LVI is an independent factor for progression in patients with high-risk NMIBC'''. | ||
**#** '''Use of LVI as a prognostic variable on transurethral resection (TUR) specimen requires prospective validation''' | **#** '''Use of LVI as a prognostic variable on transurethral resection (TUR) specimen requires prospective validation''' | ||
**#* In NIMBC, LVI is associated with increased risk of recurrence and progression in BCG-treated patients with T1 | **#* In NIMBC, LVI is associated with increased risk of recurrence and progression in BCG-treated patients with T1 NMIBC[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4719750/ §] | ||
**# '''<span style="color:#ff0000">Aggressive histological | **# '''<span style="color:#ff0000">Aggressive histological variants such as (3): micropapillary, plasmacytoid, and sarcomatoid</span>''' | ||
**#* See Bladder Cancer: Pathology & TNM Staging | **#* See Bladder Cancer: Pathology & TNM Staging | ||
**#* '''<span style="color:#ff0000">Associated with under-staging and early progression to muscle invasive disease</span>''' | **#* '''<span style="color:#ff0000">Associated with under-staging and early progression to muscle invasive disease</span>''' | ||