title: Exploration of risk factors predicting outcomes for primary T1 high-grade bladder cancer and validation of the Spanish Urological Club for Oncological Treatment scoring model: Long-term follow-up experience at a single institute.
abstract: OBJECTIVE
  To determine the prognostic factors of primary T1 high-grade bladder cancer and to validate the Spanish Urological Club for Oncological Treatment model in Japanese patients with T1 high-grade bladder cancer treated at a single institution.
  
  
  METHODS
  Records of 106 patients with T1 high-grade bladder cancer treated from 1998 to 2013 were retrospectively reviewed. Variables included various clinicopathological parameters, including lymphovascular invasion and tumor growth pattern at the invasion front. Recurrence-free survival and progression-free survival were analyzed. Multivariate Cox proportional regression analysis was used to verify the prognostic significance of the variables. Scores for recurrence and progression were calculated using the Spanish Urological Club for Oncological Treatment model.
  
  
  RESULTS
  Of 106 patients, 44 (42%) had recurrence and 16 (15%) developed progression after a median (interquartile range) follow-up period of 54 months (range 32-81 months). Non-papillary shape was the only independent predictor for recurrence, while broad-based tumor stalk and infiltrative tumor growth pattern at the invasion front were determined to be independent predictors for progression. Stratification of patients according to the number of progression risk factors yielded hazard ratios of 10.1 and 13.1 in patients having one and two risks, respectively, compared with those without any risks. The Spanish Urological Club for Oncological Treatment model successfully stratified our patients with a trend toward different probabilities of recurrence and progression.
  
  
  CONCLUSIONS
  The results of the present study might be helpful for counseling certain patients towards intensive treatment, such as radical cystectomy and/or platinum-based systemic chemotherapy. In addition, the Spanish Urological Club for Oncological Treatment model might be applicable to Japanese patients with T1 high-grade bladder cancer.
authors: Department of Urology, Nara Medical University, Nara, Japan.
authors: Makito
authors: M
authors: Miyake
authors: Department of Urology, Nara Medical University, Nara, Japan.
authors: Daisuke
authors: D
authors: Gotoh
authors: Department of Pathology, Nara Medical University, Nara, Japan.
authors: Keiji
authors: K
authors: Shimada
authors: Department of Urology, Nara Medical University, Nara, Japan.|Department of Pathology, Nara Medical University, Nara, Japan.
authors: Yoshihiro
authors: Y
authors: Tatsumi
authors: Department of Urology, Nara Medical University, Nara, Japan.
authors: Yasushi
authors: Y
authors: Nakai
authors: Department of Urology, Nara Medical University, Nara, Japan.
authors: Satoshi
authors: S
authors: Anai
authors: Department of Urology, Nara Medical University, Nara, Japan.
authors: Kazumasa
authors: K
authors: Torimoto
authors: Department of Urology, Nara Medical University, Nara, Japan.
authors: Katsuya
authors: K
authors: Aoki
authors: Department of Urology, Nara Medical University, Nara, Japan.
authors: Nobumichi
authors: N
authors: Tanaka
authors: Department of Pathology, Nara Medical University, Nara, Japan.
authors: Noboru
authors: N
authors: Konishi
authors: Department of Urology, Nara Medical University, Nara, Japan.
authors: Kiyohide
authors: K
authors: Fujimoto
mesh_terms: D000368:Aged; D002295:Carcinoma, Transitional Cell / Q000473:pathology* / Q000601:surgery; D018450:Disease Progression; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007564:Japan; D008297:Male; D008875:Middle Aged; D060787:Neoplasm Grading; D009361:Neoplasm Invasiveness; D009364:Neoplasm Recurrence, Local / Q000473:pathology*; D012189:Retrospective Studies; D018570:Risk Assessment / Q000379:methods; D012307:Risk Factors; D015996:Survival Rate; D013997:Time Factors; D001749:Urinary Bladder Neoplasms / Q000473:pathology* / Q000601:surgery
keywords: Spanish Urological Club for Oncological Treatment scoring model; bladder cancer; broad base; high grade; infiltrative pattern