Selection of adjuvant intravesical therapies using the European Organization for Research and Treatment of Cancer scoring system in patients at intermediate risk of non-muscle-invasive bladder cancer.

Abstract

We investigated whether the European Organization for Research and Treatment of Cancer (EORTC) scoring system can be used for the selection of adjuvant intravesical therapies for individual patients who undergo transurethral resection (TURB) for non-muscle-invasive bladder cancer (NMIBC). We retrospectively analyzed the data of 469 TURB cases for NMIBC. Clinical and pathological variables were compared using univariate and multivariate Cox proportional hazards regression analyses. The recurrence-free survival (RFS) rate was estimated by the Kaplan-Meier method, and the log-rank test was used to compare groups divided according to EORTC score or type of adjuvant therapy. The overall RFS rate at 1 and 3 years was 59.1 and 40.3%, respectively. Of the total, 424 TURB cases (90.4%) had an EORTC score of 1-9. Tumor number, size, and grade were significant predictors of time to recurrence. The EORTC score was a significant predictor of RFS according to multivariate analysis, and the hazard ratios increased according to each EORTC score in multivariate analysis of a combination of EORTC score and adjuvant therapies. In groups with intermediate recurrence risk as defined by the European Association of Urology guidelines, the recurrence prevention effects in patients with an EORTC score of ≥ 5 were significantly greater with intravesical Bacillus Calmette-Guérin therapy than with weekly intravesical chemotherapy. The EORTC scoring system provides useful information for the selection of adjuvant therapies for patients at intermediate risk of NMIBC recurrence.