Predicting nonmuscle invasive bladder cancer recurrence and progression in patients treated with bacillus Calmette-Guerin: the CUETO scoring model.
OBJECTIVE
Bacillus Calmette-Guerin is the most effective therapy for nonmuscle invasive bladder cancer. Recently to calculate the risks of recurrence and progression based on data from 7 European Organisation for Research and Treatment of Cancer trials a scoring system was reported. However, in that series only 171 patients were treated with bacillus Calmette-Guerin. We developed a risk stratification model to provide accurate estimates of recurrence and progression probability after bacillus Calmette-Guerin.


METHODS
Data were analyzed on 1,062 patients treated with bacillus Calmette-Guerin and included in 4 Spanish Urological Club for Oncological Treatment trials. Stepwise multivariate Cox models were used to determine the effect of prognostic factors. In each patient the weight of all factors was summed to a total score. Patients were then divided into groups, and cumulative recurrence and progression rates were calculated.


RESULTS
A scoring system was calculated with a score of 0 to 16 for recurrence and 0 to 14 for progression. Patients were categorized into 4 groups by score, and recurrence and progression probabilities were calculated in each group. For recurrence the variables were gender, age, grade, tumor status, multiplicity and associated Tis. For progression the variables were age, grade, tumor status, T category, multiplicity and associated Tis. For recurrence calculated risks using Spanish Urological Club for Oncological Treatment tables were lower than those obtained with Sylvester tables. For progression probabilities were lower in our model only in patients with high risk tumors.


CONCLUSIONS
We propose a scoring model to stratify the risk of recurrence and progression in patients treated with bacillus Calmette-Guerin.
Fernandez-Gomez
Jesus
J
Department of Urology, Hospital Central of Asturias, University of Oviedo, Oviedo, Spain. jmfernandezgomez@telefonica.net
Madero
Rosario
R
Solsona
Eduardo
E
Unda
Miguel
M
Martinez-Piñeiro
Luis
L
Gonzalez
Marcelino
M
Portillo
Jose
J
Ojea
Antonio
A
Pertusa
Carlos
C
Rodriguez-Molina
Jesus
J
Camacho
Jose Emilio
JE
Rabadan
Mariano
M
Astobieta
Ander
A
Montesinos
Manuel
M
Isorna
Santiago
S
Muntañola
Pedro
P
Gimeno
Anabel
A
Blas
Miguel
M
Martinez-Piñeiro
Jose Antonio
JA
D000276:Adjuvants, Immunologic / Q000627:therapeutic use*; D000368:Aged; D000369:Aged, 80 and over; D001500:BCG Vaccine / Q000627:therapeutic use*; D018450:Disease Progression; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015233:Models, Statistical; D009361:Neoplasm Invasiveness; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology*; D011379:Prognosis; D001749:Urinary Bladder Neoplasms / Q000188:drug therapy* / Q000453:epidemiology* / Q000473:pathology
D000276:Adjuvants, Immunologic; D001500:BCG Vaccine