To investigate the cadence of recurrence in patients with low grade intermediate-risk non-muscle invasive bladder cancer (LG IR-NMIBC) based on clinical determinants. We aim to describe patterns in rates of recurrence to better inform surveillance regimens for this chronic, burdensome, and costly disease.
Using baseline and follow-up data from participants in the West Midlands' (United Kingdom, UK) Bladder Cancer Prognosis Programme (BCPP), we assessed overall recurrence rate and recurrence-free intervals throughout the follow-up period for IR-NMIBC participants. Recurrence-free intervals were calculated using the Kaplan-Meier method.
We identified 379 patients with G1/G2 pTa tumors classified as intermediate risk. Median age was 70 and 284/379 (75%) were male. The median follow-up time was 4.2 years (95% CI: 3.9-4.8). After 5 years of follow-up, 53% of patients had at least one recurrence. One-year recurrence-free survival (RFS) was 75% and 4-year RFS was 50%. The median time to or between 1st, 2nd, 3rd, 4th, and 5th sequential recurrences was 49, 19, 12, 14, and 10 months, respectively.
Over half of patients with IR-NMIBC are destined to recur. Our data suggest that a subset of patients experience acceleration of recurrence over time and that this acceleration may serve as a potential kinetic biomarker for these individuals that could inform surveillance intervals and future treatment strategies.
Urology. 2024 Jul 17 [Epub ahead of print]
Alex Sankin, Priya Dave, Louise-Rae Cherrill, Rebecca H Boucher, Maurice P Zeegers, K K Cheng, Nicholas D James, Ilir Agalliu, Richard T Bryan
Department of Urology, Montefiore Medical Center and Albert Einstein College of Medicine, Bronx, NY. Electronic address: ., Department of Urology, Montefiore Medical Center and Albert Einstein College of Medicine, Bronx, NY., Cancer Research United Kingdom Clinical Trials Unit, Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, UK., Maastricht University, Schools of NUTRIM and CAPHRI, Department of Epidemiology, Maastricht, the Netherlands., Institute of Applied Health Research, University of Birmingham, Birmingham, UK., Institute of Cancer Research, London, UK., Department of Urology, Montefiore Medical Center and Albert Einstein College of Medicine, Bronx, NY; Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY., Bladder Cancer Research Centre, Institute of Cancer and Genomic Sciences, University of Birmingham, UK.