ArticleWorld journal of urology2026
Multi-institutional external validation of the European risk classification for high-grade Ta non-muscle-invasive bladder cancer.
Article in World journal of urology, 2026. 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
purposeNon-muscle-invasive bladder cancer (NMIBC) is a heterogeneous disease, with Ta tumors accounting for about 70% of cases. Prognosis varies widely, especially among high-grade (HG) tumors, and current predictive systems remain imperfect. This study aimed to provide an external validation of the EAU 2021 classification for Ta HG tumors.
methodsA retrospective European multicenter study was conducted in 316 TaHG NMIBC. According to the presence or absence of risk factors (age > 70 years, multifocality, tumor size > 3 cm), we categorized TaHG between intermediate-risk (IR) and high-risk (HR) NMIBC. Oncological outcomes included overall and HG recurrence-free survival (RFS), progression free-survival (PFS), cystectomy free-survival (CFS), cancer specific survival (CSS) and overall survival (OS). Uni- and multivariable Cox regression analyses were used to identify the independent predictors of disease recurrence and progression.
resultsOverall, 197 (62%) and 119 (38%) patients had IR and HR HG Ta NMIBC, respectively. All patients received endovesical instillations (BCG or chemotherapy). After a median follow-up of 36.0 [32.0; 42.0] months, IR was significantly associated with a higher 3-yr overall RFS (78.6% vs. 66.5%; p = 0.01), 3-yr HG RFS (79.9% vs. 69.2%; p = 0.03) and 3-yr PFS (97.2% vs. 91.5%; p = 0.02). CFS, CSS and OS were similar between IR and HR (all p > 0.05). Multivariable Cox regression analysis confirmed that HR vs. IR group was significantly associated with overall disease recurrence (HR = 1.69; p = 0.03), HG disease recurrence; (HR = 1.58; p = 0.04) and disease progression (HR = 2.33; p = 0.05).
conclusionThe European classification of TaHG NMIBC offers useful prognostic insight, especially concerning disease recurrence and progression.
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