Introduction & Objectives: The European Organization for Research and Treatment of Cancer (EORTC) scoring system and risk table were introduced in the 2008 European Association of
Urology guidelines on TaT1 bladder cancer. The EORTC risk tables are tables that divide patients into four groups by score and three groups by risk (low risk, intermediate risk, and high risk). These were developed to aid in the selection of treatment after performing transurethral bladder tumor resections.There is no such studies conducted to formulate guidelines for this set of patients in our country. Hence we compared the recurrence and progression rate as predicted by EORTC risk tables and the actual recurrence and progression in our patients who underwent transurethral resection of bladder cancer (TURB).
Materials and Methods: The medical records of 223 patients who underwent TURB and
were diagnosed with non-muscle-invasive bladder cancer from 2007 to 2012 in Institute of Nephrourology(INU) were analyzed. The median duration of follow up was 58.5months. The patients were divided into 2 groups: the recurrence group and the progression group. According to the EORTC scoring system, the patients in each group were categorized in terms of number of tumors, tumor size, prior recurrence rate, T category, carcinoma in situ, and pathologic grade and the scores were summed. According to the summed scores, the recurrence group and the progression group were divided into 3 subgroups: low, intermediate, and high risk, respectively. The recurrence rate and progression rate of each group were compared with the EORTC risk tables. Statistical analysis done using Independent sample t test , chi square test and fischer exact test. Binomial single proportion test is used to compare our results to standard EORTC results.
Results & observations: In the univariate analysis, age, presence of T1G3, grade, number, size, and stage of the tumor, concomitant CIS, and prior recurrence rate were statistically significant for the prediction of recurrence and disease progression (p<0.05).The recurrence rate and progression rate were almost similar to the EORTC risk tables. However, the recurrence rate was higher in the high risk group(Recurrence score=5-9) at 1 year(p=0.0002) and lower at 5 year(p=0.0001) and the progression was higher at 1 year for intermediate group(Progression score=2-6)(p=0.0018) which were statistically significant(p value <0.05).
Conclusions: EORTC scoring system and risk tables is effective and applicable even in indian population in predicting the recurrence and progression of non-muscle-invasive bladder cancer after transurethral resection of the bladder cancer and hence aids in selecting the appropriate treatment.