Utility of EORTC and CUETO Scoring Models in the Estimation of Recurrence and Progression of Non-Muscle-Invasive Bladder Cancer

Objectives: Worldwide, Non-Muscle-Invasive Bladder Cancer (NMIBC) patients are characterized by a high rate of recurrence and progression highlighting the need for a valuable prognostic estimation for better management of this disease. Thus, the present preliminary study was planned to evaluate the validation of the European Organization for Research and Treatment of Cancer (EORTC) and the Spanish Urological Club for Oncological Treatment (CUETO) risk tables to predict recurrence and progression in Moroccan patients with NMIBC. Methods: A total of 56 NMIBC patients that have undergone transurethral resection of bladder tumor (TURBT), between January 2017 and May 2021, were recruited. The recurrence and progression rates at 1 and 5 years were calculated for each patient using EORTC and CUETO scoring models and compared to EORTC and CUETO risk tables. KaplanMeier was performed to validate stratification and difference between the four groups obtained. A univariate analysis using the Cox regression test was realized to evaluate the association between prognostic factors with recurrence and progression of the disease. Results: For the 56 NMIBC patients, the median follow-up duration was 49.68 months. In this cohort, 43 patients had recurrent tumors, and 27 showed progression to an advanced stage and/or grade. At 1-year progression and recurrence rates were higher than the values predicted by the EORTC and CUETO risk tables, while both tables overestimate the long-term risk probabilities of recurrence and progression. Only the CUETO model successfully stratified our patients with statistically significant differences between the four groups of recurrence (p=0.005). Of particular interest, univariate Cox analysis indicated that only prior recurrence rate had a significant effect on both recurrence-free survival (p=0.04) and progression-free survival (p=0.037). Conclusion: CUETO scoring model is better than EORTC for recurrence stratification in Moroccan patients with NMIBC. Both models overestimate risk in 1-year and underestimate risk in 5-years. A prospective study should be realized in large cohorts to establish an ideal prognosis model for Moroccan NMIBC patients.

Automated summary

This preliminary study evaluated the validity of the EORTC and CUETO risk tables in predicting recurrence and progression in Moroccan NMIBC patients. The results showed that the CUETO scoring model was better for recurrence stratification, while both tables overestimated the risk in 1-year and underestimated the risk in 5-years. Prior recurrence rate had a significant effect on both recurrence-free survival and progression-free survival.