Oncology Department, Military Institute of Medicine, 128 Szaserów St., 04-141, Warsaw, Poland.
Internal Diseases, Nephrology and Dialysis Department, Military Institute of Medicine, 128 Szaserów St., 04-141, Warsaw, Poland.
J Cancer Res Clin Oncol. 2020 Aug;146(8):2099-2108. doi: 10.1007/s00432-020-03202-0. Epub 2020 Apr 1.
After transurethral resection of a bladder tumor, patients frequently have a recurrence of the disease, thereby requiring adjuvant therapy.
The study aimed to determine the prognostic value of expression levels of p53, Ki-67, and survivin, and to develop a new prognostic model for patients with non-muscle-invasive bladder cancer (NMIBC) after transurethral resection of a bladder tumor.
The study group consisted of 101 patients with primary NMIBC. Univariate followed by multivariate Cox proportional hazard regression analysis was performed to obtain a model including the smallest possible number of descriptive variables with the highest statistical significance and impact on risk.
The RECINT model (RECurrence In Not Treated) including factors independently associated with cancer recurrence (tumor size [HR 1.148; p = 0.034], intensity of the color reaction for p53 [HR 1.716; p = 0.008], Ki-67 [HR 3.001; p = 0.022], and survivin [HR 1.461; p = 0.021]) adequately stratified recurrence free-survival (R = 0.341, p < 0.001) in patients with primary NMIBC. Patients with the lowest RECINT score (0-6) had the lowest probability of cancer recurrence (1- and 5-year recurrence of 16%) in comparison with other groups (p < 0.001).
The RECINT model may be useful for stratifying the risk of recurrence in patients with non-muscle-invasive bladder cancer and may allow for identification of those who may benefit the most from adjuvant BCG immunotherapy.
经尿道膀胱肿瘤切除术（TURBT）后，患者常出现疾病复发，从而需要辅助治疗。
本研究旨在确定 p53、Ki-67 和 survivin 表达水平的预后价值，并为 TURBT 术后非肌层浸润性膀胱癌（NMIBC）患者建立新的预后模型。
本研究纳入 101 例初发 NMIBC 患者。采用单因素和多因素 Cox 比例风险回归分析，获得一个包含描述性变量数量尽可能少、具有最高统计学意义和对风险影响最大的模型。
RECINT 模型（未治疗时的复发，RECurrence In Not Treated）包括与肿瘤复发独立相关的因素（肿瘤大小[HR 1.148；p=0.034]、p53 显色强度[HR 1.716；p=0.008]、Ki-67 [HR 3.001；p=0.022]和 survivin [HR 1.461；p=0.021]），可充分分层初发 NMIBC 患者的无复发生存率（R=0.341，p<0.001）。与其他组相比，RECINT 评分最低（0-6 分）的患者癌症复发概率最低（1 年和 5 年复发率分别为 16%）（p<0.001）。
RECINT 模型可用于分层 NMIBC 患者的复发风险，可能有助于确定最有可能从辅助 BCG 免疫治疗中获益的患者。
