Clinical Validation of the Intermediate-risk Non–muscle-invasive Bladder Cancer Scoring System

Maria Natalia Gandur Quiroga shared on LinkedIn:

“Clinical Validation of the Intermediate-risk Non–muscle-invasive Bladder Cancer Scoring System

Introduction:

The International Bladder Cancer Group (IBCG) recently proposed an updated scoring model for IR substratification, aimed at refining the management and follow-up of these patients.

A multicenter study conducted by the Young Academic Urologists Urothelial Working Group provides the first clinical validation of this model, potentially paving the way for its incorporation into clinical practice.

Study Overview:

This international, multicenter, retrospective study included patients diagnosed with IR NMIBC between 2012 and 2022. These patients, treated with transurethral resection of the bladder (TURB) and adjuvant intravesical chemotherapy, were categorized into IR-low, IR-intermediate, and IR-high groups based on the presence of five key risk factors: tumor size, multifocality, early recurrence, frequent recurrence, and failure of previous intravesical treatment.

The primary outcomes assessed were the 1-year and 3-year rates of recurrence-free survival (RFS) and progression-free survival (PFS).

Key Findings:

Patient Characteristics: Among the 677 patients included, 79% were male, with a median age of 70 years. Tumor size >3 cm and multifocal disease were present in 7% and 48% of patients, respectively.

Recurrence and Progression Rates: The overall 1-year and 3-year RFS rates were 85.4% and 62.0%, respectively, while the PFS rates were 99.4% and 97.9%. The IR-high group exhibited significantly higher recurrence and progression rates compared to the IR-low and IR-intermediate groups.

Validation of the IBCG Model: The study confirmed that the IBCG scoring system effectively stratifies patients into distinct risk groups, with the IR-high group showing similar progression rates to high-risk NMIBC as defined by the European Association of Urology (EAU) 2021 guidelines.

Discussion:

The validation of the IBCG model addresses the urgent need for a refined risk stratification tool for IR NMIBC. This model can guide personalized treatment decisions and follow-up schedules, ensuring that patients with higher risks receive more intensive surveillance and adjuvant therapies.

Moreover, this model’s incorporation into clinical practice could lead to better resource allocation, especially in scenarios like BCG shortages.

Conclusion:

This study provides robust clinical validation of the IBCG scoring system and substratification model, supporting its potential adoption in clinical guidelines.

This advancement represents a significant step towards personalized medicine for patients with IR NMIBC, optimizing treatment outcomes and improving patient care.

Source: Maria Natalia Gandur Quiroga /LinkedIn

Maria Natalia Gandur Quiroga is a Medical Oncologist and Chief of the Division of Genitourinary Medical Oncology at the Instituto de Oncología Ángel H. Roffo in Buenos Aires, Argentina. She is a Professor of Medicine at the University of Buenos Aires at the Oncologists Post Graduates Studies.

Her research focuses on clinical trials with aims to improve the treatment of patients with urologic tumors.  She is an active member of the European Association for Cancer Research, Argentinian Medical Association and American Society of Clinical Oncology.