Evidence map›Paper›PMID 39739061›Full record

ArticleWorld journal of urology2024

Identifying optimal candidates for active surveillance in low-grade intermediate-risk non-muscle invasive bladder cancer.

Paolo Zaurito, Pietro Scilipoti, Mattia Longoni, Mario de Angelis, Chiara Re, Leonardo Quarta, Giovanni Tremolada, Giusy Burgio, Francesco Pellegrino, Giuseppe Rosiello and 7 more

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Article in World journal of urology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. Article
  2. Review
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

17 authors.

Paolo Zaurito *Division of Experimental Oncology, Unit of Urology, Urological Research Institute, IRCCS Ospedale San Raffaele, Via Olgettina, 60, 20132, Milan, Italy.
Pietro Scilipoti *Division of Experimental Oncology, Unit of Urology, Urological Research Institute, IRCCS Ospedale San Raffaele, Via Olgettina, 60, 20132, Milan, Italy. scilipoti.pietro@hsr.it.
Mattia LongoniDivision of Experimental Oncology, Unit of Urology, Urological Research Institute, IRCCS Ospedale San Raffaele, Via Olgettina, 60, 20132, Milan, Italy.
Mario de AngelisDivision of Experimental Oncology, Unit of Urology, Urological Research Institute, IRCCS Ospedale San Raffaele, Via Olgettina, 60, 20132, Milan, Italy.
Chiara ReDivision of Experimental Oncology, Unit of Urology, Urological Research Institute, IRCCS Ospedale San Raffaele, Via Olgettina, 60, 20132, Milan, Italy.
Leonardo QuartaDivision of Experimental Oncology, Unit of Urology, Urological Research Institute, IRCCS Ospedale San Raffaele, Via Olgettina, 60, 20132, Milan, Italy.
Giovanni TremoladaDivision of Experimental Oncology, Unit of Urology, Urological Research Institute, IRCCS Ospedale San Raffaele, Via Olgettina, 60, 20132, Milan, Italy.
Giusy BurgioDivision of Experimental Oncology, Unit of Urology, Urological Research Institute, IRCCS Ospedale San Raffaele, Via Olgettina, 60, 20132, Milan, Italy.
Francesco PellegrinoDivision of Experimental Oncology, Unit of Urology, Urological Research Institute, IRCCS Ospedale San Raffaele, Via Olgettina, 60, 20132, Milan, Italy.
Giuseppe RosielloDivision of Experimental Oncology, Unit of Urology, Urological Research Institute, IRCCS Ospedale San Raffaele, Via Olgettina, 60, 20132, Milan, Italy.
Andrea NecchiDivision of Experimental Oncology, Unit of Urology, Urological Research Institute, IRCCS Ospedale San Raffaele, Via Olgettina, 60, 20132, Milan, Italy.
Renzo ColomboDivision of Experimental Oncology, Unit of Urology, Urological Research Institute, IRCCS Ospedale San Raffaele, Via Olgettina, 60, 20132, Milan, Italy.
Giorgio GandagliaDivision of Experimental Oncology, Unit of Urology, Urological Research Institute, IRCCS Ospedale San Raffaele, Via Olgettina, 60, 20132, Milan, Italy.
Andrea SaloniaDivision of Experimental Oncology, Unit of Urology, Urological Research Institute, IRCCS Ospedale San Raffaele, Via Olgettina, 60, 20132, Milan, Italy.
Francesco MontorsiDivision of Experimental Oncology, Unit of Urology, Urological Research Institute, IRCCS Ospedale San Raffaele, Via Olgettina, 60, 20132, Milan, Italy.
Alberto BrigantiDivision of Experimental Oncology, Unit of Urology, Urological Research Institute, IRCCS Ospedale San Raffaele, Via Olgettina, 60, 20132, Milan, Italy.
Marco MoschiniDivision of Experimental Oncology, Unit of Urology, Urological Research Institute, IRCCS Ospedale San Raffaele, Via Olgettina, 60, 20132, Milan, Italy.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveThe intermediate-risk non-muscle invasive bladder cancer (IR-NMIBC) prognostic group is heterogeneous. Growing evidence supports the role of active surveillance (AS) for patients with low-risk NMIBC, however, no clear data exists considering IR-NMIBC. The aim of the study was to assess the risk of recurrence of patients eligible for AS based on the International Bladder Cancer Group (IBCG) stratification.

methodsWe retrospectively evaluated 174 LG IR-NMIBC patients who underwent transurethral resection of bladder tumor (index TURBT) from 2012 to 2023 at a tertiary referral center and fulfilled the inclusion criteria for enrollment in AS protocols at the index TURBT (≤ 5 suspicious lesions, no macrohematuria, negative urine cytology, lesions ≤ 1 cm). Patients were then stratified according to the International Bladder Cancer Group (IBCG) risk factors: frequent recurrence, early recurrence, previous instillation, and multifocality. Kaplan Meier plots and multivariable Cox regression analysis (MVA) were used to assess the risk of any and high-grade (HG) recurrence according to the number of risk factors.

resultsOverall, 168 (97%) patients had a Ta low grade bladder tumor. After a median follow-up of 36 months [Interquartile range (IQR) 20-54], 75 (43%) and 32 (18%) patients experienced any- and HG recurrence, respectively. The 3-year recurrence free-survival (RFS) was 86% [95% Confidence Interval (CI) 76-98%] for patients with 0, 76% (95% CI 68-84%) for those with 1-2, and 54% (95% CI 34-84%) for those with ≥ 3 risk factors. The 3-year HG-RFS was > 90% for patients with 0 and 1-2 risk factors, compared to 76% (95% CI 58-99%) for those with ≥ 3 risk factors. At MVA, the presence of ≥ 3 risk factors was associated with a higher risk of recurrence [hazard ratio: 4.74, 95% CI 1.75-12.8, p = 0.002].

conclusionAmong patients with LG IR-NMIBC eligible for AS, those with more than 2 IBCG risk factors may not be suitable candidates due to a higher risk of developing HG recurrence. Randomized controlled trials with standardized AS protocols are necessary to validate these findings and optimize patient selection for AS in LG IR-NMIBC.

Indexed as

Neoplasm GradingNeoplasm InvasivenessNeoplasm Recurrence, LocalUrinary Bladder NeoplasmsWatchful WaitingAgedFemaleHumansMaleMiddle AgedNon-Muscle Invasive Bladder NeoplasmsPatient SelectionRetrospective StudiesRisk AssessmentActive surveillanceIntermediate riskInternational bladder cancer groupLow-gradeNon-muscle invasive bladder cancer

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.