The evaluation of the risk factors for non-muscle invasive bladder cancer (NMIBC) recurrence after transurethral resection (TURBt) in Chinese population

Shenghua Liu; Junyao Hou; Hu Zhang; Yishuo Wu; Mengbo Hu; Limin Zhang; Jianfeng Xu; Rong Na; Haowen Jiang; Qiang Ding

doi:10.1371/journal.pone.0123617

The evaluation of the risk factors for non-muscle invasive bladder cancer (NMIBC) recurrence after transurethral resection (TURBt) in Chinese population

PLoS One. 2015 Apr 7;10(4):e0123617. doi: 10.1371/journal.pone.0123617. eCollection 2015.

Authors

Shenghua Liu¹, Junyao Hou¹, Hu Zhang¹, Yishuo Wu¹, Mengbo Hu¹, Limin Zhang¹, Jianfeng Xu², Rong Na¹, Haowen Jiang¹, Qiang Ding¹

Affiliations

¹ Fudan Institute of Urology, Huashan Hospital, Fudan University, Shanghai, China; Department of Urology, Huashan Hospital, Fudan University, Shanghai, China.
² Fudan Institute of Urology, Huashan Hospital, Fudan University, Shanghai, China; Department of Urology, Huashan Hospital, Fudan University, Shanghai, China; State Key Laboratory of Genetic Engineering, School of Life Science, Fudan University, Shanghai, China; Center for Cancer Genomics, Wake Forest School of Medicine, Winston-Salem, NC, United States of America.

Abstract

Objective: The risk factors of bladder cancer recurrence after transurethral resection of bladder tumor (TURBt) were poorly understood, especially in Chinese population. This study evaluated the potential risk factors of recurrence based on a Chinese population.

Materials and methods: A total of 698 patients that received TURBt procedure in our institute from 2000 to 2012 were recruited in this study. Clinical information was collected. The patients were followed up according to the schedule recommended by Chinese guideline.

Results: A total of 583 males (83.5%) and 115 females (16.5%) were enrolled in our study. The median follow-up duration was 51.5 months. Gender, chief complain, tumor size, number of lesions, histological grade and chemotherapeutic agents were found significantly associated with patients' short-term recurrence (less than 1 year) (All p<0.05). In the multivariate analysis, tumor size, number of lesions, histological grade and chemotherapeutic agents were significantly related to patients' short-term recurrence (less than 1 year) (All p<0.05). A multivariate model based on tumor size, number of lesions, histological grade and chemotherapeutic agents had an AUC of 0.697, which significantly improved the prediction utility for bladder cancer short-term recurrence (less than 1 year) than any single factor In the multivariate Cox regression, tumor size greater than 3 cm, multifocal lesions, worsen histological grade and non-urothelial carcinoma was related to time to recurrence (TR).

Conclusion: Patients with larger tumor size, multifocal number of lesions, higher tumor grade and who received chemotherapeutic agents other than Epirubicin and Pirarubicin might have higher risks of recurrence less than 1 year. Tumor size, number of lesions, pathology and histological grade might be associated with TR. As Bacille Calmette-Guerin (BCG) is currently not approved for bladder cancer in China, Epirubicin and Pirarubicin might be considered prior to other chemotherapy medications when providing post-operative instillation of chemotherapy.

Publication types

Evaluation Study
Research Support, Non-U.S. Gov't

MeSH terms

Aged
Carcinoma, Transitional Cell / pathology
Carcinoma, Transitional Cell / surgery*
China / epidemiology
Cystectomy / adverse effects*
Female
Humans
Incidence
Male
Middle Aged
Neoplasm Invasiveness
Neoplasm Recurrence, Local / diagnosis*
Neoplasm Recurrence, Local / epidemiology*
Neoplasm Staging
Risk Factors
Urinary Bladder Neoplasms / pathology
Urinary Bladder Neoplasms / surgery*

Grants and funding

The study was supported by National Natural Science Foundation of China (Grand No. 81272853, 81402339). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.