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A recent study analyzing the recurrence patterns in nonmuscle-invasive bladder cancer patients over 26 years suggests that individuals without recurrence at 5 years might consider transitioning to less invasive monitoring strategies based on risk categorization.

The following is a summary of “Surveillance for Nonmuscle Invasive Bladder Cancer: Identifying the Point of Diminishing Returns,” published in the NOVEMBER 2023 issue of Urology by Ranti, et al.

For a study, researchers sought to characterize the patterns of first and second recurrences in patients with nonmuscle-invasive bladder cancer (NMIBC) over 26 years using cohort-level follow-up and microsimulation modeling.

Patients diagnosed with NMIBC in Stockholm County between 1995 and 1996 were included in the study. Clinical, pathological, and longitudinal follow-up data were collected. Various statistical analyses, including logistic regressions, Kaplan Meier curves, and Cox proportional hazards models, were conducted to establish assumptions for a microsimulation model. The model simulated first and second recurrences and disease progression for a simulated cohort of 10,000 patients.

The study included 386 patients, of whom 67.4% were male, over 50% had TaLG tumors, and 37.5% were classified as American Urological Association high-risk. The median time to recurrence was 300 days, with only three patients needing more data. The cohort has been followed for 26 years. Simulated first-recurrence rates over 15 years for low-risk, intermediate-risk, and high-risk patients were 56.6%, 62.8%, and 48.7%, respectively, with muscle-invasive (MI) progression rates of 2.2%, 4.3%, and 14.3%. For second recurrences, 70.7%, 75.7%, and 84.7% of low, medium, and high-risk patients recurred. Notably, no first recurrences were observed after 9 years, but there were low but observable rates beyond 5 years.

The findings suggested that patients categorized as low, intermediate, and high-risk without recurrence at 5 years may potentially transition to less invasive monitoring strategies.

Source: goldjournal.net/article/S0090-4295(23)00697-0/fulltext