ArticleBladder cancer (Amsterdam, Netherlands)2022
Combination of Two T1 Substaging Systems (T1a/b/c and T1m/e) Better Predicts Tumor Outcomes in Patients with T1 High Grade Bladder Cancer.
Article in Bladder cancer (Amsterdam, Netherlands), 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundT1 substaging is a predictive factor for non-muscle-invasive bladder cancer, and two types of T1 substaging systems (T1a/b/c and T1m/e) are currently in use. However, the predictive ability of both systems is poor, and there is debate over which system is better.
objectiveTo confirm whether combination of two T1 substaging systems can improve the predictive ability of T1 substaging for tumor outcomes.
methodsPatients with primary pT1 high-grade bladder cancer from three centers were included. All tumors were assessed with T1a/b/c and T1m/e substaging. A new variable named COMB was developed in which patients were stratified into T1a/b&T1m, T1a/b&T1e, T1c&T1m or T1c&T1e subgroups. A time-dependent receiver operating characteristic curve (ROC) analysis was used to test whether the accuracy of prediction could be improved with COMB.
resultsA total of 239 patients with primary pT1HG were analyzed. No tumor was T1c&T1m, and therefore, only three types of combinations were evaluated: T1a/b&T1m (62 patients), T1a/b&T1e (124 patients) and T1c&T1e (53 patients). Regardless of all patients or those treated with Re-TURBt and adequate BCG, patients with T1a/b&T1m have the best prognosis, and those with T1c&T1e have the poorest prognosis. The time-dependent ROC showed that, for both recurrence and progression, COMB had a higher AUC than T1a/b/c and T1m/e, regardless of population.
conclusionsCompared with either system alone, the combination of two T1 substaging systems improves the predictive ability of T1 substaging for tumor outcomes.
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