Xu Meng-Yao, Sun Jian-Xuan, Xiang Yu-Xi, Hua Zi-Jin, Liu Chen-Qian, An Ye, Xu Jin-Zhou, Zhang Si-Han, Liu Zheng, Wang Shao-Gang, Xia Qi-Dong
Department and Institute of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Division of Endocrinology, Department of Internal Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Transl Androl Urol. 2025 Jan 31;14(1):91-102. doi: 10.21037/tau-24-535. Epub 2025 Jan 22.
Post-operative recurrence for patients with intermediate and high-risk non-muscular invasive bladder cancer (NMIBC) is common. This study aims to evaluate the potential factors of tumor recurrence, and construct a novel nomogram to predict the probability of tumor recurrence.
We retrospectively enrolled patients with intermediate and high-risk NMIBC who received thulium laser resection of bladder tumors (TmLRBT) or transurethral resection of the bladder tumor (TURBT) followed by intravesical bacille Calmette-Guérin (BCG) immunotherapy. The risk factors were screened by the least absolute shrinkage and selection operator (LASSO) regression method. And multivariate logistic regression was applied to recognize the independent risk factors of bladder cancer recurrence. A nomogram was established, and the recurrence probability was calculated based on the model scores.
A total of 90 patients with intermediate and high-risk NMIBC were included in this study, of whom 53 underwent TURBT and 37 underwent TmLRBT. During the follow-up period, 22 patients (24.4%) experienced bladder cancer recurrence. Three variables were screened out in the LASSO regression. The multivariate logistic analysis suggested that surgery of TURBT [odds ratio (OR) =6.86760; 95% confidence interval (CI): 1.5048-31.34300] and previous bladder tumor (OR =14.73600; 95% CI: 2.81180-77.23000) were independent risk factors of recurrence, while more BCG treatment sessions (OR =0.26504; 95% CI: 0.12455-0.56398) was independent protective factor of recurrence.
Patients with TURBT and previous bladder tumor history were more likely to develop recurrent bladder cancer, while more BCG treatment sessions was independent protective factor of recurrence.
中高危非肌层浸润性膀胱癌（NMIBC）患者术后复发很常见。本研究旨在评估肿瘤复发的潜在因素，并构建一种新型列线图以预测肿瘤复发概率。
我们回顾性纳入了接受膀胱肿瘤铥激光切除术（TmLRBT）或经尿道膀胱肿瘤切除术（TURBT）并随后进行膀胱内卡介苗（BCG）免疫治疗的中高危NMIBC患者。通过最小绝对收缩和选择算子（LASSO）回归方法筛选危险因素。并应用多因素逻辑回归来识别膀胱癌复发的独立危险因素。建立列线图，并根据模型得分计算复发概率。
本研究共纳入90例中高危NMIBC患者，其中53例行TURBT，37例行TmLRBT。在随访期间，22例患者（24.4%）出现膀胱癌复发。LASSO回归筛选出3个变量。多因素逻辑分析表明，TURBT手术（比值比[OR]=6.86760；95%置信区间[CI]：1.5048 - 31.34300）和既往膀胱肿瘤（OR =14.73600；95% CI：2.81180 - 77.23000）是复发的独立危险因素，而更多的BCG治疗疗程（OR =0.26504；95% CI：0.12455 - 0.56398）是复发的独立保护因素。
接受TURBT且有既往膀胱肿瘤病史的患者更易发生复发性膀胱癌，而更多的BCG治疗疗程是复发的独立保护因素。
