External validation of EORTC risk scores to predict recurrence after transurethral resection of brazilian patients with non -muscle invasive bladder cancer stages Ta and T1

Vol. 42 (5): 932-941, September – October, 2016

doi: 10.1590/S1677-5538.IBJU.2015.0169


Gilberto L. Almeida 1,2 , Wilson F. S. Busato Jr. 1, Carmen Marcondes Ribas 2, Jurandir Marcondes Ribas-Filho 2, Ottavio De Cobelli 3,4

1Universidade do Vale do Itajaí, SC, Brasil/Instituto Catarinense de Urologia (INCAU), Itajaí, Brasil; 2Faculdade Evangélica do Paraná (FEPAR)/Instituto de Pesquisas Médicas (IPEM), Curitiba, Brasil; 3Università degli Studi di Milano, Milano, Italia; 4 Dipartimento di Urologia, Istituto Europeo di Oncologia (IEO), Milano, Italia


Validate the EORTC risk tables in Brazilian patients with NMIBC.

Methods: 205 patients were analyzed. The 6 parameters analyzed were: histologic grading, pathologic stage, size and number of tumors, previous recurrence rate and concomitant CIS. The time for first recurrence (TFR), risk score and probability of re­currence were calculated and compared to the probabilities obtained from EORTC risk tables. C-index was calculated and accuracy of EORTC tables was analyzed. Results: pTa was presented in 91 (44.4%) patients and pT1 in 114 (55.6%). Ninety-seven (47.3%) patients had solitary tumor, and 108 (52.7%) multiple tumors. One hundred and three (50.2%) patients had tumors smaller than 3 cm and 102 (40.8%) had bigger than 3 cm. Concomitant CIS was observed in 21 (10.2%) patients. Low grade was presented in 95 (46.3%) patients, and high grade in 110 (53.7%). Intravesical therapy was utilized in 105 (56.1%) patients. Recurrence was observed in 117 (57.1%) patients and the mean TFR was 14,2 ± 7,3 months. C-index was 0,72 for 1 year and 0,7 for 5 years. The recurrence risk was 28,8% in 1 year and 57,1% in 5 years, independently of the scoring risk. In our population, the EORTC risk tables overestimated the risk of recurrence in 1 year and underestimated in 5 years.

Conclusion: The validation of the EORTC risk tables in Brazilian patients with NMIBC was satisfactory and should be stimulated to predict recurrence, although these may overestimated the risk of recurrence in 1 year and underestimated in 5 years.

Keywords: Urinary Bladder; Carcinoma; Recurrence; Transurethral Resection of Prostate

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