The value of tumour weight as a predictive factor for recurrence and progression in non-muscle invasive bladder cancer

• Published in: Scandinavian journal of urology Vol. 54; no. 1; p. 40
• Main Authors: Fernández-Conejo, Guillermo, de la Peña, Enrique, Hernández, Virginia, Guijarro, Ana, Castro, Alejandro, Pérez-Fernández, Elia, Llorente, Carlos
• Format: Journal Article
• Language: English
• Published: England 02.01.2020
• Subjects: Aged; Aged, 80 and over; Carcinoma, Transitional Cell - pathology; Carcinoma, Transitional Cell - surgery; Cystoscopy; Disease Progression; Female; Humans; Male; Middle Aged; Muscle, Smooth - pathology; Neoplasm Invasiveness; Neoplasm Recurrence, Local - epidemiology; Prognosis; Proportional Hazards Models; Tumor Burden; Urinary Bladder Neoplasms - pathology; Urinary Bladder Neoplasms - surgery; recurrence; urinary bladder neoplasms; Weights and measures; disease progression
• ISSN: 2168-1813
• DOI: 10.1080/21681805.2019.1708968

To further assess the influence of the weight after TURBT as a predictive factor for recurrence and progression in NMIBC. A cohort of patients with a first episode of NMIBC between 1999 and 2016 was analysed retrospectively. We studied the correlation between the tumour's size and weight, the time-dependent ROC curves for the optimal weight value for the prediction of recurrence and progression and their association with the risk of recurrence and progression at one and five years. We analysed 470 patients who met inclusion criteria. Median (IQR) follow-up time was four years (2.2-6.7), 227 (48.3%) patients had a recurrence and 46 (9.8%) progressed. Median (IQR) weight after resection was 2 g (0.8-6) and its correlation with size was 0.56. The optimal value for the prediction of recurrence was 4 g. The RFS at one and five years with a weight <4 g was 77.7% and 53.5%, respectively, compared to 57.8% and 34.7% with higher weight (  < .001). PFS at one and five years was 98% and 92.7% for a weight <4 g compared to 91.4% and 83.1% for tumours >4 g, respectively (  = .02). On multivariate analysis, a higher weight was associated with an increased risk of recurrence: HR [95%:CI] = 1.52[1.05-1.86], and progression: HR[95%:CI] = 1.87[1.01-3.47] (  < .05). The weight of the specimen obtained after TURBT is a predictive factor of both recurrence and progression in NMIBC that may be more accurate than tumour size and easily and objectively measured. An increase of 52% and 87% in the risk of recurrence and progression, respectively, was found in tumours weighing more than 4 g.