Usefulness of the Spanish Urological Club for Oncological Treatment scoring model to predict nonmuscle invasive bladder cancer recurrence in patients treated with intravesical bacillus Calmette-Guérin plus interferon-α.

Abstract

PURPOSE: The Spanish Urological Club for Oncological Treatment recently developed a scoring model to stratify the recurrence risk in patients treated with intravesical bacillus Calmette-Guérin using gender, age, grade, tumor status, T category, multiplicity and associated carcinoma in situ. We investigated the ability of this model to stratify the recurrence risk in patients with nonmuscle invasive bladder cancer undergoing combination bacillus Calmette-Guérin plus interferon α-2B therapy. MATERIALS AND METHODS: We retrospectively reviewed data from a national multicenter phase II trial of bacillus Calmette-Guérin plus interferon α-2B in patients with nonmuscle invasive bladder cancer to identify 718 with the data required to use the model. Recurrence was defined as visible tumor on cystoscopy unless histologically confirmed as benign, definitive positive cytology or biopsy proven disease even with negative cystoscopy. Time to recurrence was indexed to the first intravesical treatment date. Patients were assigned points based on the model and then divided into 4 groups based on total score, including 0 to 4, 5 or 6, 7 to 9 and 10 or greater. RESULTS: The model successfully stratified the recurrence risk into 4 statistically different groups based on score with a 3-year recurrence-free rate of 58%, 52%, 42% and 26% for scores of 0 to 4, 5 or 6, 7 to 9 and 10 or greater, respectively (p < 0.001). CONCLUSIONS: The Spanish Urological Club for Oncological Treatment scoring model is a useful prognostic tool to stratify recurrence risk in patients with nonmuscle invasive bladder cancer who are treated with combined intravesical bacillus Calmette-Guérin plus interferon α-2B. Larger, prospective trials are required for full model validation.