The Risk Stratifications in Non-Muscle Invasive Bladder Cancer: How Much Accurate are the Methods That We Use? A Multi-Directional View

Abstract

Non-muscle invasive bladder cancer (NMIBC) have heterogeneous pattern inside, rapid recurrence might be seen in some of the patients while earlier progression might be seen in other patients. Recently, European Organization for Research and Treatment of Cancer (EORTC) risk tables are the most commonly used as scoring systems in stratifying the risk group in NMIBC. The scoring system was developed based on tumor number and size, prior recurrence rate, T stage, concurrent CIS and tumor grade, thus the total score should be calculated individually for recurrence and progression. EAU guidelines also advices stratifying the patients into 3 risk groups according to the prognostic factors and data from the EORTC tables. In addition, the maintenance BCG therapy, secondary TUR operation, substaging in T1 tumors, pathological variants of uroepithelial carcinoma, lymphovascular invasion and some molecular markers have been reported to significantly affect the prognosis of NMIBC in consecutive studies. Today, EORTC and other stratification remains valid, however, needs to be improved and validated under the guidance of the previous studies.