以更新版歐洲泌尿科醫學會風險分群分析非肌肉侵入性膀胱癌病人存活：亞洲族群

吳英龍¹、林子平^1,2、陳光國^1,2、林登龍^1,2、張延驊^1,2、郭俊逸^1,2、鍾孝仁^1,2、吳宏豪^1,2、

盧星華^1,2、黃逸修^1,2、林志杰^1,2、范玉華^1,2、黃奕燊^1,2、黃子豪¹、顧明軒¹、黃志賢^1,2

臺北榮民總醫院泌尿部¹ ； 國立陽明交通大學醫學院泌尿學科及書田泌尿科學研究中心²

Survival outcomes of non-muscle invasive bladder urothelial carcinoma patients stratified by the updated EAU risk groups: Asian cohort

Ying-Long Wu¹, Tzu-Ping Lin^1,2, Kuang-Kuo Chen^1,2, Alex T.L. Lin^1,2, Yen-Hwa Chang^1,2,

Junne-Yih Kuo^1,2, Hsiao-Jen Chung^1,2, Howard H.H. Wu^1,2, Shing-Hwa Lu ^1,2, Eric Yi-Hsiu Huang^1,2, Chi-Cheh Lin^1,2, Yu-Hua Fan^1,2, I-shen Huang^1,2, Tzu-Hao Huang¹, Ming-Xuan Gu¹,

William J.S. Huang^1,2

Department of Urology, Taipei Veterans General Hospital¹,

Department of Urology, College of Medicine and Shu-Tien Urological Science Research Center, National Yang Ming Chiao Tung University², Taipei, Taiwan

Purpose: Risk stratification models for non-muscle invasive bladder urothelial carcinoma (NMIBC) have well been established such as the European Organization for Research and Treatment of Cancer (EORTC) risk tables. An updated European Association of Urology guideline in 2021 included only primary bladder urothelial carcinoma to facilitate treatment recommendations and we aimed to validate the model with our Taiwanese single center cohort..

Materials and Methods: We collected total 666 patients from 2007to 2017 in Taipei Veterans General hospital who had been diagnosed with primary NMIBC through transurethral resection of bladder tumor (TURBT). The cumulative survival rate was analyzed. The follow-up period was until Dec-2021.

Results: We stratified our patients into low, intermediate, and high risk according to the EAU 2021 stratification. The mean age was 71.9 years and the mean follow-up period was 90.9 months. The overall cumulative survival rate was shown in figure 1. The overall survival rate was 56.3% and 78.5%, 59.4%, and 46.9% in the low, intermediate, and high risk groups, respectively. Both recurrence-free survival and progression-free survival curves were compatible with the risk stratifications as shown in Figures 2 and 3.

The multivariate analysis showed age>70 (HR 3.07, p<0.01) and the presence of muscularis propria in pathology specimen (HR 1.35, p=0.014) are statistically significant.

Conclusions: It showed that the EAU 2021 NMIBC risk groups could successfully stratify overall, recurrence, and progression-free survival in our Asian cohort. We also found the depth of our pathology specimen influenced the overall survival rate. Further study might be warranted to validate the applicability of EAU risk groups in different ethnic patients.