Clinicopathologic Prognostic Factors in NMIBC for Recurrence & Progression

Introduction: Transitional cell carcinoma (TCC) accounts for more than 90% of all the bladder cancers out of which 70% are non-muscle invasive bladder cancer (NMIBC) at diagnosis. The high rate of recurrence and progression following transurethral bladder resection of tumor makes the follow up essential as well as crucial in detecting early recurrence of tumor. In our study, we investigated the predictive value of various factors for recurrence and disease progression which could help in identifying patients for early definitive treatment.

Objectives: To determine the predictive factors of recurrence and progression of NMIBC managed in a single centre.

Methods: Retrospective study of 256 patients of NMIBC after TURBT was done to review the factors related with recurrence and progression. Bivariable analysis (Chi square test &Mann U Whitney test) and multivariable binary logistic regression were used to identify predictors of recurrence and progression.

Results: On multivariate analysis, patients with tumor-size >3 cm and multiple tumors were found to have 1.7 times and 3 times greater odd of recurrence respectively as compared to patients with tumor size < 3cm and single tumor. Patients diagnosed with T1 stage and multiple lesions were found to have 1.9 times and 1.8 times greater odds of progression respectively as compared to patients with Ta stage and single lesion. With regard to quantitative factors, none of them were significantly associated for prediction for recurrence and progression.

Conclusion: Multiple tumors had increased risk for the development of both recurrence and disease progression. Size of tumor >3 cm is a risk factor for the development of recurrence and T1 stage was found to be a risk-factor for progression of the disease.