Evidence map›Paper›PMID 40979267›Full record

ArticleEuropean urology open science2025

Applicability of the European Association of Urology 2021 Prognostic Model for Non-muscle-invasive Bladder Cancer in a Swedish Population-based Cohort.

Fredrik Liedberg, Oskar Hagberg, Irene J Beijert, Firas Aljabery, Truls Gårdmark, Abolfazl Hosseini, Staffan Jahnson, Tomas Jerlström, Henrik Kjölhede, Per-Uno Malmström and 6 more

Abstract readLetter
In one paragraph

Article in European urology open science, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing 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

1 citing paper in PubMed.

  1. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

16 authors.

Fredrik LiedbergDepartment of Translational Medicine, Lund University, Malmö, Sweden.
Oskar HagbergDepartment of Translational Medicine, Lund University, Malmö, Sweden.
Irene J BeijertDepartment of Surgical Oncology (Urology), Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands.
Firas AljaberyDepartment of Clinical and Experimental Medicine, Division of Urology, Linköping University, Linköping, Sweden.
Truls GårdmarkDepartment of Urology, Danderyd Hospital, Stockholm, Sweden.
Abolfazl HosseiniDepartment of Urology, Danderyd Hospital, Stockholm, Sweden.
Staffan JahnsonDepartment of Clinical and Experimental Medicine, Division of Urology, Linköping University, Linköping, Sweden.
Tomas JerlströmDepartment of Urology, School of Medical Sciences, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
Henrik KjölhedeDepartment of Urology, Sahlgrenska University Hospital and Sahlgrenska Academy Institute of Clinical Sciences, University of Gothenburg, Gothenburg, Sweden.
Per-Uno MalmströmDepartment of Surgical Sciences, Uppsala, University, Uppsala, Sweden.
Viveka StröckDepartment of Urology, Sahlgrenska University Hospital and Sahlgrenska Academy Institute of Clinical Sciences, University of Gothenburg, Gothenburg, Sweden.
Karin SöderkvistDepartment of Diagnostics and Intervention, Oncology, Umeå University, Umeå, Sweden.
Anders UllénDepartment of Pelvic Cancer, Genitourinary Oncology and Urology Unit, Theme Cancer, Karolinska University Hospital, Stockholm, Sweden.
Bas W G van RhijnDepartment of Surgical Oncology (Urology), Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands.
Lars HolmbergDepartment of Surgical Sciences, Uppsala, University, Uppsala, Sweden.
Christel HäggströmDepartment of Surgical Sciences, Uppsala, University, Uppsala, Sweden.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

The European Association of Urology (EAU) 2021 prognostic model for non-muscle-invasive bladder cancer (NMIBC) is based on the World Health Organization (WHO) 1973 and/or WHO 2004/2022 grading systems for patients who did not receive bacillus Calmette-Guérin (BCG) instillations and is widely used to assess the risk of progression. The estimated risk of progression affects the type of adjuvant intravesical instillation (chemotherapy or BCG), with primary radical cystectomy recommended for patients with the highest risk of progression. We applied the EAU 2021 prognostic model in a population-based setting for 3392 patients with primary NMIBC diagnosed in 2013-2014 according to the BladderBaSe 2.0 database. We assessed the model calibration by comparing the 5-yr progression probability observed in our cohort with the predicted progression probability assigned for the risk groups in the original EAU study, and evaluated the discrimination according to Harrell's C index. At 5-yr follow-up, 394 patients had experienced disease progression. The progression probability observed was 4.9% (95% confidence interval [CI] 3.5-6.3%), 8.6% (95% CI 6.9-10%), 25% (95% CI 22-28%), and 23% (95% CI 14-30%) for the low-, intermediate-, high-, and very high-risk groups, respectively. The discrimination at 5 yr was 0.72 (95% CI 0.69-0.78) for the overall cohort and 0.74 (95% CI 0.70-0.80) in the group excluding the 811 patients who received BCG instillations. Showing moderate predictive ability, the EAU 2021 prognostic model has clinical utility in population-based settings despite underestimation of the observed progression risk in the low- and high-risk groups in the current study. Patient summary: We looked at how well a model predicted the risk of progression of non-muscle-invasive bladder cancer using results for a group of Swedish patients. Approximately one in four patients in the high-risk category progress to more advanced disease within 5 yr. Doctors and patients need to consider the probability of progression in the high-risk category when making shared decisions on which treatment is best for an individual patient.

Indexed as

Adjuvant treatmentNon–muscle-invasive bladder cancerPrimary radical cystectomyPrognostic modeProgression risk

Identifiers

PMID40979267
PMCPMC12445608

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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.