Prognostic factors for the recurrence, progression, and multiple recurrences of non-muscle-invasive bladder cancer in Eastern Taiwan

Abstract

 

Objectives: This study aimed to identify the prognostic factors that influence the recurrence, progression, and multiple recurrences of non-muscle-invasive bladder cancerr (NMIBC) based on data from the Hualien Tzu Chi Hospital, Taiwan. Materials and Methods: A retrospective cohort study enrolled patients with NMIBC diagnosed between 2005 and 2022 who underwent transurethral resection of bladder tumor (TUR‑BT). Demographic, clinical, and pathological data, along with recurrence outcomes, were collected. Cox proportional hazard regression models were used to analyze the factors associated with recurrence, progression to muscle‑invasive disease, and risk for multiple recurrences. Results: Overall, 199 patients were included, with a mean follow‑up duration of 4.6 years. Tumors recurred in 53.8% of the patients, which further progressed to muscle‑invasive bladder cancer (MIBC) in 13.1%. Multivariate Cox regression analysis identified betel nut chewing, multiple tumors, high‑grade tumors, and lack of bacillus Calmette–Guérin (BCG) therapy as significant predictors of recurrence. Age, high‑grade tumors, and recurrence within 3 months after the initial TUR‑BT were the significant predictors of progression. Multiple tumors and early recurrence occurring within 3 months after the initial TUR‑BT were significantly associated with the risk of experiencing multiple recurrences. Conclusion: This study identified multiple tumors, high‑grade tumors, and BCG therapy as the significant factors associated with NMIBC recurrence, with a potential link also observed for betel nut chewing. Age, tumor grade, and early recurrence emerged as the key predictors of progression to MIBC. In addition, multiple tumors and early recurrence were linked to an increased risk of experiencing multiple recurrences.

 

Keywords: Bladder cancer, Nonmuscle invasive, Risk factors, Tumor recurrence