Analysis of risk factors of recurrence in non-muscle invasive bladder cancer patients after initial transurethral resection of bladder tumor

doi:10.19401/j.cnki.1007-3639.2023.05.008

Abstract

Abstract:

Background and purpose: The recurrence rate of non-muscle invasive bladder cancer (NMIBC) after transurethral resection of bladder tumor (TURBT) is high. There are few studies on the risk factors of recurrence in NMIBC patients after initial TURBT. Our study aimed to screen the high-risk population and take corresponding preventive intervention measures by analyzing the risk factors of recurrence in NMIBC patients after initial TURBT. Methods: A total of 197 NMIBC patients who received initial TURBT in The Cancer Hospital of the University of Electronic Science and Technology of China from December 2015 to May 2020 were selected and followed up for 24 to 77 months. Patients were divided into recurrence group (48 cases) and non-recurrence group (149 cases) according to the results. Univariate analysis was performed on the clinical data of the two groups, and the indicators with statistical significance were included in the multivariate logistic regression analysis to screen the possible risk factors of recurrence. Results: Univariate analysis showed that the difference was statistically significant between two groups in gross hematuria, secondary resection, T1 stage, high grade tumor, multiple tumor and lack of immediate intravesical therapy (P <0.05).There was no significant difference in gender, age, family history of tumor, smoking history, tumor size and subsequent intravesical therapy between two groups (P>0.05). The receiver operating characteristic (ROC) curves of the ratio of neutrophils to lymphocytes and the ratio of neutrophils and hemoglobin to lymphocytes showed no statistically significant difference between two groups (P>0.05). Multivariate logistic regression analysis showed that T1 stage, high grade tumor, multiple tumor and lack of immediate intravesical therapy were independent risk factors of recurrence in NMIBC patients after initial TURBT (P<0.05, OR > 1). Conclusion: The recurrence of NMIBC patients after initial TURBT is closely related to tumor stage, tumor grade, tumor number and immediate intravesical therapy. Corresponding intervention measures can be taken to reduce the postoperative recurrence rate in initial NMIBC patients.

Key words: Non-muscle invasive bladder cancer, Initial transurethral resection of bladder tumor, Recurrence, Risk factors

CLC Number:

R737.14

TANG Duocai, ZHOU Shukui, ZHANG Guiyin, LIU Lei, LIAO Hong. Analysis of risk factors of recurrence in non-muscle invasive bladder cancer patients after initial transurethral resection of bladder tumor[J]. China Oncology, 2023, 33(5): 478-483.

Figures/Tables 2

References 27

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Data	Recurrence	No recurrence	χ²	P value
Gender			0.130	0.718
Male	37	111
Female	11	38
Age/year			1.421	0.233
≥65	26	66
<65	22	83
Family history of tumor			0.000	1.000
Yes	4	14
No	44	135
Smoking history			0.125	0.724
Yes	31	92
No	17	57
Gross hematuria			4.307	0.038
Yes	45	121
No	3	28
Secondary resection			4.109	0.043
Yes	26	56
No	22	93
Tumor stage			21.170	0.000
T₁	37	58
T_a	11	91
Tumor grade			23.530	0.000
G₁	10	91
G₃	38	58
Multiple tumor			12.994	0.000
No	14	88
Yes	34	61
Tumor size/cm			2.588	0.108
≥5	4	3
<5	44	146
Immediate intravesical therapy			15.469	0.000
Yes	38	145
No	10	4
Accomplish subsequent intravesical therapy			0.185	0.667
Yes	43	130
No	5	19

Data	β	Standard error	Wald	P value	OR (95% CI)
Secondary resection	0.163	0.409	0.159	0.690	1.177 (0.528-2.625)
Gross hematuria	0.633	0.679	0.868	0.352	1.883 (0.497-7.131)
Tumor stage	1.031	0.443	5.419	0.020	2.803 (1.177-6.674)
Tumor grade	1.145	0.477	5.750	0.016	3.142 (1.233-8.008)
Multiple tumor	0.810	0.399	4.128	0.042	2.247 (1.029-4.907)
Immediate intravesical therapy	1.758	0.680	6.686	0.010	5.800 (1.530-21.987)