How good are we at predicting outcomes in non-muscle invasive bladder cancer?

Abstract

Being able to accurately predict a non-muscle invasive bladder cancer patient's risk of recurrence and progression to muscle invasive disease is important for choosing the most appropriate treatment after transurethral resection and for scheduling further follow up. European Association of Urology guidelines are based on tools for predicting patient outcome which have been developed by the EORTC and by CUETO. These tools are reviewed and their limitations and discrepancies are discussed. The need to improve the identification of which T1G3/HG patients are at the highest risk of progression to muscle invasive disease is highlighted. Although improvements in risk stratification may be based on molecular markers, more work in this field on their identification and validation is needed before they can be incorporated into daily clinical practice. Because patients who progress have a very poor prognosis, the identification of those factors that significantly increase our ability to identify, at an early stage, patients who progress on intravesical treatment should be a top research priority.