Late recurrence in patients with non‐muscle‐invasive bladder cancer after 5‐year cancer‐free periods

• Published in: International journal of urology Vol. 29; no. 10; pp. 1140 - 1146
• Main Authors: Hirata, Yurie, Higuchi, Madoka, Osawa, Takahiro, Hinotsu, Shiro, Harabayashi, Toru, Mochizuki, Tango, Enami, Nobuyasu, Nounaka, Osamu, Shinno, Yuichiro, Kikuchi, Hiroshi, Matsumoto, Ryuji, Abe, Takashige, Murai, Sachiyo, Shinohara, Nobuo
• Format: Journal Article
• Language: English
• Published: Australia Wiley Subscription Services, Inc 01.10.2022
• Subjects: Bladder cancer; Cancer; Classification systems; Humans; Invasiveness; late recurrence; Neoplasm Invasiveness; Neoplasm Recurrence, Local - epidemiology; Neoplasm Recurrence, Local - pathology; NMIBC; Patients; Retrospective Studies; Risk Factors; Tumors; TURBT; Urinary Bladder Neoplasms - pathology; urothelial carcinoma; urothelial carcinoma; NMIBC; TURBT; bladder cancer; late recurrence
• ISSN: 0919-8172; 1442-2042; 1442-2042
• DOI: 10.1111/iju.14936

Objectives There is no consensus about the follow‐up schedule after 5‐year cancer‐free periods. In this study, we aimed to elucidate the risk factors for the recurrence in patients with non‐muscle‐invasive bladder cancer who remained cancer free for more than 5 years. Methods Data from six Japanese institutions were retrospectively reviewed. Among the patients with non‐muscle‐invasive bladder cancer who were treated with transurethral resection of bladder tumor between 1990 and 2013, those who had no recurrence for more than 5 years were included in this study. The Kaplan–Meier method and Cox hazards model were used to estimate recurrence‐free survival and to determine the pathologic and clinical factors affecting late recurrence. Results In total, 434 patients were enrolled in this study. Of these patients, 55 patients (12.7%) experienced late recurrence. The median follow‐up time was 8.9 years (interquartile range 6.9–11.3 years). Prior history of bladder cancer before the most recent transurethral resection was a significant predictor for late recurrence (hazard ratio 1.99 [95% confidence interval 1.13–3.47], P = 0.019), although other clinical factors including tumor grade, pathologic stage, tumor multiplicity, and current risk classification systems were not associated with late recurrence. Conclusions Late recurrence after a long tumor‐free period is not rare and it was not predicted by current risk classification systems. Only prior history of bladder cancer was a significant predictor for late recurrence in this study.