Accuracy of the EORTC risk tables and of the CUETO scoring model to predict outcomes in non-muscle-invasive urothelial carcinoma of the bladder Journal Article


Authors: Xylinas, E.; Kent, M.; Kluth, L.; Pycha, A.; Comploj, E.; Svatek, R. S.; Lotan, Y.; Trinh, Q. D.; Karakiewicz, P. I.; Holmang, S.; Scherr, D. S.; Zerbib, M.; Vickers, A. J.; Shariat, S. F.
Article Title: Accuracy of the EORTC risk tables and of the CUETO scoring model to predict outcomes in non-muscle-invasive urothelial carcinoma of the bladder
Abstract: Background:The European Organization for Research and Treatment of Cancer (EORTC) risk tables and the Spanish Urological Club for Oncological Treatment (CUETO) scoring model are the two best-established predictive tools to help decision making for patients with non-muscle-invasive bladder cancer (NMIBC). The aim of the current study was to assess the performance of these predictive tools in a large multicentre cohort of NMIBC patients.Methods:We performed a retrospective analysis of 4689 patients with NMIBC. To evaluate the discrimination of the models, we created Cox proportional hazard regression models for time to disease recurrence and progression. We incorporated the patients calculated risk score as a predictor into both of these models and then calculated their discrimination (concordance indexes). We compared the concordance index of our models with the concordance index reported for the models.Results:With a median follow-up of 57 months, 2110 patients experienced disease recurrence and 591 patients experienced disease progression. Both tools exhibited a poor discrimination for disease recurrence and progression (0.597 and 0.662, and 0.523 and 0.616, respectively, for the EORTC and CUETO models). The EORTC tables overestimated the risk of disease recurrence and progression in high-risk patients. The discrimination of the EORTC tables was even lower in the subgroup of patients treated with BCG (0.554 and 0.576 for disease recurrence and progression, respectively). Conversely, the discrimination of the CUETO model increased in BCG-treated patients (0.597 and 0.645 for disease recurrence and progression, respectively). However, both models overestimated the risk of disease progression in high-risk patients.Conclusion:The EORTC risk tables and the CUETO scoring system exhibit a poor discrimination for both disease recurrence and progression in NMIBC patients. These models overestimated the risk of disease recurrence and progression in high-risk patients. These overestimations remained in BCG-treated patients, especially for the EORTC tables. These results underline the need for improving our current predictive tools. However, our study is limited by its retrospective and multi-institutional design. © 2013 Cancer Research UK.
Keywords: adult; controlled study; aged; cancer surgery; major clinical study; histopathology; cancer recurrence; cancer growth; cancer risk; multimodality cancer therapy; cancer adjuvant therapy; outcome assessment; follow up; cancer grading; diagnostic accuracy; bcg vaccine; cancer immunotherapy; maintenance therapy; retrospective study; prediction; high risk patient; risk assessment; multicenter study; cancer size; scoring system; mitomycin; bladder surgery; transitional cell carcinoma; non muscle invasive bladder cancer; european organization for research and treatment of cancer; spanish urological club for oncological treatment; transurethral resection of the bladder
Journal Title: British Journal of Cancer
Volume: 109
Issue: 6
ISSN: 0007-0920
Publisher: Nature Publishing Group  
Date Published: 2013-09-17
Start Page: 1460
End Page: 1466
Language: English
DOI: 10.1038/bjc.2013.372
PROVIDER: scopus
PMCID: PMC3776972
PUBMED: 23982601
DOI/URL:
Notes: --- - "Export Date: 1 November 2013" - "CODEN: BJCAA" - "Source: Scopus"
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MSK Authors
  1. Andrew J Vickers
    565 Vickers
  2. Matthew T Kent
    26 Kent