This is a preprint, a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
A new preprint design is coming!
We have improved readability, clarity, accessibility, and opportunities for engagement.
Research article
Konrad Stawiski
Medical University of Lodz
Corresponding Author
ORCiD: https://orcid.org/0000-0002-6550-3384
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Purpose: To validate and summarize current evidence about the reliability of EORTC, CUETO and EAU risk stratification in prediction of recurrence, progression and death of patients with initially non-muscle-invasive bladder cancer (NMIBC).Methods: Retrospective cohort analysis of 322 patients with newly diagnosed NMIBC. We assessed the concordance (Harrell's c-index) of our results with calculated risk scores in Cox proportional hazard regression models and utilized receiver operating characteristic curve analysis (area under curve; AUCROC). Lastly, to further confirm our observations we conducted a systematic reviewResults: 1-year and 5-year c-indices ranged from 0.55 to 0.66 for recurrence and from 0.72 to 0.82 for progression. AUCROC of predictions ranged from 0.46 for 1-year recurrence risk based on CUETO groups to 0.82 for 1-year progression risk based on EAU risk groups. The accuracy of prediction was lower for patients treated with BCG maintenance immunotherapy. EORTC model (overall c-index c=0.64; 95%CI:0.61-0.68) was superior to EAU (p=0.035; 0.62; 95%CI: 0.59-0.66) and CUETO (p<0.001; c=0.53; 95%CI:0.50-0.56) model in recurrence prediction. EORTC model (c=0.82; 95%CI:0.77-0.86) also performed better than CUETO (p=0.008; c=0.73; 95%CI:0.66-0.81) but there was no sufficient evidence that it performed better than EAU (p=0.572; c=0.81; 95%CI:0.77-0.84) for predicting progression. EORTC and CUETO comparably predicted progression in BCG-treated EAU high-risk patients (p=0.48).Conclusions: The division into risk groups by EORTC, CUETO and EAU offered moderately accurate predictions about recurrence and progression of NMIBC, which emphasizes the urgent need for the development of more personalized and accurate predictive tool. EORTC provided the best recurrence and progression prediction.
Keywords
non-muscle-invasive bladder cancer, prediction, risk stratification, bladder cancer, systematic review
Figure 1
Figure 2
This is a list of supplementary files associated with this preprint. Click to download.
Loading...
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
History
CURRENT STATUS: Posted
Version 1
Posted 30 Aug, 2019
No community comments so far
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Urology & Nephrology
Learn more about our company.
A new preprint design is coming!
We have improved readability, clarity, accessibility, and opportunities for engagement.
This is a preprint, a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Research article
Konrad Stawiski
Medical University of Lodz
Corresponding Author
ORCiD: https://orcid.org/0000-0002-6550-3384
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
History
CURRENT STATUS: Posted
Version 1
Posted 30 Aug, 2019
No community comments so far
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Urology & Nephrology
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Purpose: To validate and summarize current evidence about the reliability of EORTC, CUETO and EAU risk stratification in prediction of recurrence, progression and death of patients with initially non-muscle-invasive bladder cancer (NMIBC).Methods: Retrospective cohort analysis of 322 patients with newly diagnosed NMIBC. We assessed the concordance (Harrell's c-index) of our results with calculated risk scores in Cox proportional hazard regression models and utilized receiver operating characteristic curve analysis (area under curve; AUCROC). Lastly, to further confirm our observations we conducted a systematic reviewResults: 1-year and 5-year c-indices ranged from 0.55 to 0.66 for recurrence and from 0.72 to 0.82 for progression. AUCROC of predictions ranged from 0.46 for 1-year recurrence risk based on CUETO groups to 0.82 for 1-year progression risk based on EAU risk groups. The accuracy of prediction was lower for patients treated with BCG maintenance immunotherapy. EORTC model (overall c-index c=0.64; 95%CI:0.61-0.68) was superior to EAU (p=0.035; 0.62; 95%CI: 0.59-0.66) and CUETO (p<0.001; c=0.53; 95%CI:0.50-0.56) model in recurrence prediction. EORTC model (c=0.82; 95%CI:0.77-0.86) also performed better than CUETO (p=0.008; c=0.73; 95%CI:0.66-0.81) but there was no sufficient evidence that it performed better than EAU (p=0.572; c=0.81; 95%CI:0.77-0.84) for predicting progression. EORTC and CUETO comparably predicted progression in BCG-treated EAU high-risk patients (p=0.48).Conclusions: The division into risk groups by EORTC, CUETO and EAU offered moderately accurate predictions about recurrence and progression of NMIBC, which emphasizes the urgent need for the development of more personalized and accurate predictive tool. EORTC provided the best recurrence and progression prediction.
Figure 1
Figure 2
This is a list of supplementary files associated with this preprint. Click to download.
Loading...