The value of tumour weight as a predictive factor for recurrence and progression in non-muscle invasive bladder cancer

Abstract

Objective: To further assess the influence of the weight after TURBT as a predictive factor for recurrence and progression in NMIBC.

Materials and methods: A cohort of patients with a first episode of NMIBC between 1999 and 2016 was analysed retrospectively. We studied the correlation between the tumour’s size and weight, the time-dependent ROC curves for the optimal weight value for the prediction of recurrence and progression and their association with the risk of recurrence and progression at one and five years.

Results: We analysed 470 patients who met inclusion criteria. Median (IQR) follow-up time was four years (2.2–6.7), 227 (48.3%) patients had a recurrence and 46 (9.8%) progressed. Median (IQR) weight after resection was 2 g (0.8–6) and its correlation with size was 0.56. The optimal value for the prediction of recurrence was 4 g. The RFS at one and five years with a weight <4 g was 77.7% and 53.5%, respectively, compared to 57.8% and 34.7% with higher weight (p < .001). PFS at one and five years was 98% and 92.7% for a weight <4 g compared to 91.4% and 83.1% for tumours >4 g, respectively (p = .02). On multivariate analysis, a higher weight was associated with an increased risk of recurrence: HR [95%:CI] = 1.52[1.05–1.86], and progression: HR[95%:CI] = 1.87[1.01–3.47] (p < .05).

Conclusion: The weight of the specimen obtained after TURBT is a predictive factor of both recurrence and progression in NMIBC that may be more accurate than tumour size and easily and objectively measured. An increase of 52% and 87% in the risk of recurrence and progression, respectively, was found in tumours weighing more than 4 g.

Keywords:

• Weights and measures
• urinary bladder neoplasms
• recurrence
• disease progression

Disclosure statement

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments ethical standards.

For this type of study formal consent is not required (a retrospective study).

This article does not contain any studies with animals performed by any of the author.

Additional information

Notes on contributors

Guillermo Fernández-Conejo

G. Fernández-Conejo: Conception and design, collection and assembly of data, data analysis and interpretation, manuscript writing, final approval of manuscript.

Enrique de la Peña

E. de la Peña: Conception and design, manuscript writing, final approval of manuscript.

Virginia Hernández

V. Hernández: data analysis and interpretation manuscript writing, final approval of manuscript.

Ana Guijarro

A. Guijarro: collection and assembly of data, manuscript writing, final approval of manuscript.

Alejandro Castro

A. Castro: collection and assembly of data, manuscript writing, final approval of manuscript.

Elia Pérez-Fernández

E. Pérez-Fernández: Data analysis and interpretation, manuscript writing, final approval of manuscript.

Carlos Llorente

C. Llorente: Conception and design, manuscript writing, final approval of manuscript.