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Purpose <p>Non-muscle-invasive bladder cancer (NMIBC) is a heterogeneous disease, with Ta tumors accounting for about 70% of cases. Prognosis varies widely, especially among high-grade (HG) tumors, and current predictive systems remain imperfect. This study aimed to provide an external validation of the EAU 2021 classification for Ta HG tumors.</p> Methods <p>A retrospective European multicenter study was conducted in 316 TaHG NMIBC. According to the presence or absence of risk factors (age &gt; 70&#xa0;years, multifocality, tumor size &gt; 3&#xa0;cm), we categorized TaHG between intermediate-risk (IR) and high-risk (HR) NMIBC. Oncological outcomes included overall and HG recurrence-free survival (RFS), progression free-survival (PFS), cystectomy free-survival (CFS), cancer specific survival (CSS) and overall survival (OS). Uni- and multivariable Cox regression analyses were used to identify the independent predictors of disease recurrence and progression.</p> Results <p>Overall, 197 (62%) and 119 (38%) patients had IR and HR HG Ta NMIBC, respectively. All patients received endovesical instillations (BCG or chemotherapy). After a median follow-up of 36.0&#xa0;[32.0;&#xa0;42.0] months, IR was significantly associated with a higher 3-yr overall RFS (78.6%&#xa0;vs. 66.5%; p = 0.01), 3-yr HG RFS (79.9%&#xa0;vs. 69.2%; p = 0.03) and 3-yr PFS (97.2%&#xa0;vs. 91.5%; p = 0.02). CFS, CSS and OS were similar between IR and HR (all p &gt; 0.05). Multivariable Cox regression analysis confirmed that HR vs. IR group was significantly associated with overall disease recurrence (HR = 1.69; p = 0.03), HG disease recurrence; (HR = 1.58; p = 0.04) and disease progression (HR = 2.33; p = 0.05).</p> Conclusion <p>The European classification of TaHG NMIBC offers useful prognostic insight, especially concerning disease recurrence and progression.</p>

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Multi-institutional external validation of the European risk classification for high-grade Ta non-muscle-invasive bladder cancer

  • 期刊论文

  • 发表日期：

    2026年5月13日

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  • Manon Cournède,
  • Pierre-Etienne Gabriel,
  • Marine Lottin,
  • Marco Moschini,
  • Francesco Soria,
  • David D’Andrea,
  • Shahrokh F. Shariat,
  • Alexandra Budowski,
  • Cédric Poyet,
  • Mathieu Roumiguie,
  • Mario Alvarez-Maestro,
  • Alberto Briganti,
  • Wojciech Krajewski,
  • Kees Hendricksen,
  • Hans Veerman,
  • Luca Afferi,
  • Agostino Mattei,
  • Carlo Di Bona,
  • Stefania Zamboni,
  • Claudio Simeone,
  • Ronan Thenault,
  • Gregory Verhoest,
  • Paolo Gontero,
  • Evanguelos Xylinas

摘要

Purpose

Non-muscle-invasive bladder cancer (NMIBC) is a heterogeneous disease, with Ta tumors accounting for about 70% of cases. Prognosis varies widely, especially among high-grade (HG) tumors, and current predictive systems remain imperfect. This study aimed to provide an external validation of the EAU 2021 classification for Ta HG tumors.

Methods

A retrospective European multicenter study was conducted in 316 TaHG NMIBC. According to the presence or absence of risk factors (age > 70 years, multifocality, tumor size > 3 cm), we categorized TaHG between intermediate-risk (IR) and high-risk (HR) NMIBC. Oncological outcomes included overall and HG recurrence-free survival (RFS), progression free-survival (PFS), cystectomy free-survival (CFS), cancer specific survival (CSS) and overall survival (OS). Uni- and multivariable Cox regression analyses were used to identify the independent predictors of disease recurrence and progression.

Results

Overall, 197 (62%) and 119 (38%) patients had IR and HR HG Ta NMIBC, respectively. All patients received endovesical instillations (BCG or chemotherapy). After a median follow-up of 36.0 [32.0; 42.0] months, IR was significantly associated with a higher 3-yr overall RFS (78.6% vs. 66.5%; p = 0.01), 3-yr HG RFS (79.9% vs. 69.2%; p = 0.03) and 3-yr PFS (97.2% vs. 91.5%; p = 0.02). CFS, CSS and OS were similar between IR and HR (all p > 0.05). Multivariable Cox regression analysis confirmed that HR vs. IR group was significantly associated with overall disease recurrence (HR = 1.69; p = 0.03), HG disease recurrence; (HR = 1.58; p = 0.04) and disease progression (HR = 2.33; p = 0.05).

Conclusion

The European classification of TaHG NMIBC offers useful prognostic insight, especially concerning disease recurrence and progression.