MP16-06: The International Bladder Cancer Group Intermediate-risk Non-muscle Invasive Bladder Cancer (IBCG IR-NMIBC) scoring system predicts the need for intervention for patients on active surveillance.
Friday, May 3, 2024 1:00 PM to 3:00 PM · 2 hr. (US/Central)
221B
Abstract
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Full Abstract and Figures
Author Block
Wei Shen Tan*, Houston, TX, Roberto Contieri, Nicolò Buffi, Giovanni Lughezzani, Milan, Italy, Valentina Grajales, Houston, TX, Mark Soloway, Hollywood, FL, Paolo Casale, Rodolfo Hurle, Milan, Italy, Ashish Kamat, Houston, TX
Introduction
Active surveillance is gaining acceptance as an option for intermediate risk (IR) non-muscle invasive bladder cancer (NMIBC). We determined if the International Bladder Cancer Group (IBCG) intermediate risk (IR)-NMIBC scoring system can predict the need for surgical intervention in low grade (LG) NMIBC managed by active surveillance (AS).
Methods
The Bladder Italian Active Surveillance (BIAS) registry, a prospective study of LG Ta/T1 NMIBC patients managed with AS was utilized. Patients with the following characteristics underwent AS: LG papillary disease, =5 suspicious lesions at recurrence, each =1 cm in diameter, absence of gross hematuria and negative urinary cytology. Delayed TURBT was offered in patients who breached the inclusion criteria or patient withdrawal. The primary endpoint was the rate of delayed TURBT for AS events. Multivariable Cox proportional-hazards analysis was used to determine factors associated with delayed TURBT following AS.
Results
A total of 163 LG Ta/T1 patients (208 AS events) were included for analysis. Delayed TURBT was performed in 109 patients (131 events) with a median follow-up of 24 (IQR: 8-60) months. Patients with no risk-factors, 1 and =2 risk-factors comprise of 41 (20%), 120 (58%) and 47 (22%) AS events respectively. Patients with 0 risk-factors were three-fold more likely to continue on AS compared to patients with =3 risk-factors at 24 months follow-up (61% versus 19%). Multivariable Cox regression model report that IBCG scoring system was associated with delayed TURBT (1-2 RF [HR: 1.8, 95% CI: 1.06-3.06, p=0.030], =3 RF [HR:3.76, 95% CI: 2.07-6.81, p<0.001]) after adjusting for age and T stage.
Conclusions
The IBCG IR-NMIBC scoring system accurately predicts outcome of LG NMIBC patients managed with AS. This may aid the counseling of patients before embarking on an AS program.
Source Of Funding
None
Author Block
Wei Shen Tan*, Houston, TX, Roberto Contieri, Nicolò Buffi, Giovanni Lughezzani, Milan, Italy, Valentina Grajales, Houston, TX, Mark Soloway, Hollywood, FL, Paolo Casale, Rodolfo Hurle, Milan, Italy, Ashish Kamat, Houston, TX
Introduction
Active surveillance is gaining acceptance as an option for intermediate risk (IR) non-muscle invasive bladder cancer (NMIBC). We determined if the International Bladder Cancer Group (IBCG) intermediate risk (IR)-NMIBC scoring system can predict the need for surgical intervention in low grade (LG) NMIBC managed by active surveillance (AS).
Methods
The Bladder Italian Active Surveillance (BIAS) registry, a prospective study of LG Ta/T1 NMIBC patients managed with AS was utilized. Patients with the following characteristics underwent AS: LG papillary disease, =5 suspicious lesions at recurrence, each =1 cm in diameter, absence of gross hematuria and negative urinary cytology. Delayed TURBT was offered in patients who breached the inclusion criteria or patient withdrawal. The primary endpoint was the rate of delayed TURBT for AS events. Multivariable Cox proportional-hazards analysis was used to determine factors associated with delayed TURBT following AS.
Results
A total of 163 LG Ta/T1 patients (208 AS events) were included for analysis. Delayed TURBT was performed in 109 patients (131 events) with a median follow-up of 24 (IQR: 8-60) months. Patients with no risk-factors, 1 and =2 risk-factors comprise of 41 (20%), 120 (58%) and 47 (22%) AS events respectively. Patients with 0 risk-factors were three-fold more likely to continue on AS compared to patients with =3 risk-factors at 24 months follow-up (61% versus 19%). Multivariable Cox regression model report that IBCG scoring system was associated with delayed TURBT (1-2 RF [HR: 1.8, 95% CI: 1.06-3.06, p=0.030], =3 RF [HR:3.76, 95% CI: 2.07-6.81, p<0.001]) after adjusting for age and T stage.
Conclusions
The IBCG IR-NMIBC scoring system accurately predicts outcome of LG NMIBC patients managed with AS. This may aid the counseling of patients before embarking on an AS program.
Source Of Funding
None