Predictive Factors of Recurrence and Progression in Non-Muscle-Invasive Bladder Cancer: A Retrospective Study of 525 Patients
TL;DR
Tumor-related factors remain key predictors of NMIBC outcomes, whereas treatment adherence and socioeconomic factors significantly influence recurrence, highlighting the need for an integrated prognostic model.
Abstract
Background: Non-muscle-invasive bladder cancer (NMIBC) is characterized by high recurrence rates and variable progression risks. Identifying predictive factors, including socioeconomic determinants, is essential for optimizing the management of this condition.Methods: We conducted a retrospective monocentric study of 525 patients with NMIBC (Ta–T1) treated between 2010 and 2023. All patients underwent complete TURBT followed by intravesical BCG according to risk stratification criteria. Recurrence was defined as histologically confirmed tumor relapse, and progression was defined as the development of muscle-invasive disease (≥T2). Survival analyses were performed using the Kaplan–Meier and log-rank tests.Results: After a median follow-up of 34 months, recurrence occurred in 34.4% of patients and progression in 17.9%. Recurrence was significantly associated with tumor size ≥3 cm (p = 0.001), multiplicity (p = 0.001), high grade (p = 0.003), smoking (p = 0.001), socioeconomic factors (p ≤ 0.005), and BCG interruption (p = 0.004). Progression was associated with T1 stage (p = 0.05), high grade (p = 0.05), tumor size ≥3 cm (p = 0.002), multiplicity (p = 0.005), smoking (p = 0.003), and BCG interruption (p = 0.005). Conclusion: Tumor-related factors remain key predictors of NMIBC outcomes, whereas treatment adherence and socioeconomic factors significantly influence recurrence. These findings highlight the need for an integrated prognostic model.