Bobiński Jarosław, Lipiński Marek
Uniwersytet Medyczny w Łodzi, II Klinika Urologii.
Pol Merkur Lekarski. 2009 Dec;27(162):524-8.
75-85% newly diagnosed bladder cancers are lesions that are not invading the muscle layer of bladder. Patients treated for bladder cancer in this stage are characterized that part of them will develop recurrent bladder cancer and it may progress. Depending on a patient's characteristics, after transurethral resection (TUR), the probability of recurrence at one year ranges from about 15% to 70% and the probability of progression at five years ranges from about 7% to 40%. Non-muscle invasive bladder cancer is a heterogeneous group of tumors with completely different oncological outcome. Taking into consideration the risk of recurrence and progression, many researchers attempted to define risk factors for bladder cancer. After many test and researches had been conducted in different research and development centres a few risk factors were detected such as: number of tumors, tumor size, recurrence rate, staging (7T), grading (G), presence of carcinoma in situ (CIS). Basing on those factors patients with non-muscle invasive bladder cancer were divided into three risk groups. Low risk group - single, diameter < 3 cm, TaG1 tumors, high risk group - multiple, diameter > 3 cm, frequently recurrent, T1G3 tumors with concomitant CIS, intermediate risk group - the rest of tumors not mentioned in prior two groups. When using this division into three risk groups there is no possible to predict the probability of bladder cancer recurrence and progression separately Although prognostic factors may indicate a high risk for recurrence, the risk for progression may still be low and other tumors may have a high risk of both recurrence and progression. In order to separately predict the short-term and long-term risks of both recurrence and progression in individual patients, the EORTC developed a scoring system and risk tables (EORTC nomograms).
75%至85%新诊断的膀胱癌是未侵犯膀胱肌肉层的病变。处于这一阶段接受膀胱癌治疗的患者的特点是，其中部分患者会发生复发性膀胱癌，且可能进展。根据患者的特征，经尿道切除术（TUR）后，一年复发概率约为15%至70%，五年进展概率约为7%至40%。非肌层浸润性膀胱癌是一组具有完全不同肿瘤学结局的异质性肿瘤。考虑到复发和进展风险，许多研究人员试图确定膀胱癌的风险因素。在不同的研发中心进行了多次测试和研究后，发现了一些风险因素，如：肿瘤数量、肿瘤大小、复发率、分期（T）、分级（G）、原位癌（CIS）的存在。基于这些因素，非肌层浸润性膀胱癌患者被分为三个风险组。低风险组——单个，直径<3 cm，TaG1肿瘤；高风险组——多个，直径>3 cm，频繁复发，伴有CIS的T1G3肿瘤；中风险组——前两组未提及的其余肿瘤。当采用这种分为三个风险组的划分方法时，无法分别预测膀胱癌复发和进展的概率。尽管预后因素可能表明复发风险高，但进展风险可能仍然较低，而其他肿瘤可能同时具有高复发风险和高进展风险。为了分别预测个体患者复发和进展的短期和长期风险，欧洲癌症研究与治疗组织（EORTC）制定了一个评分系统和风险表（EORTC列线图）。
