Predicting the risk of high-grade bladder cancer using noninvasive data

Urol Int. 2011;87(3):319-24. doi: 10.1159/000328635. Epub 2011 Aug 18.

Abstract

Aim: To examine the hypothesis that the risk of high-grade bladder cancer can be predicted using noninvasively obtained data.

Patients and methods: We retrospectively analyzed the database of 431 patients that had transurethral resection of first-time bladder tumors between June 1998 and December 2009. Pre-operative parameters evaluated were: patients' age; gender; sonographic tumor diameter, number and location of tumor inside the bladder; presence of hydronephrosis, and results of urinary cytology. Parameters that showed significance in multivariate analysis were incorporated into the nomogram.

Results: Multivariate analysis of the data showed that patient's age, the presence of hydronephrosis, sonographic tumor diameter (risk of a high-grade tumor: 14, 29, 43.3, 55.7 and 69.4% at diameters: 0.5-1.5, 1.6-2, 2.1-2.5, 2.6-3 and >3 cm, respectively), location of tumor in the bladder (risk of high-grade tumor: 28.8, 47, 67.5 and 90.5% in the lateral walls, posterior/base, anterior and dome, respectively), and urinary cytology were all highly significant and independent predictors of high-grade tumors. A nomogram constructed using these variables scored an area of 0.853 in the ROC curve.

Conclusions: The risk of high-grade bladder tumor can be accurately predicted using non-invasively obtained information. This prediction can help to triage patients with newly detected bladder cancer for biopsy.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Biopsy
  • Female
  • Humans
  • Male
  • Medical Oncology / methods
  • Middle Aged
  • Multivariate Analysis
  • ROC Curve
  • Retrospective Studies
  • Risk
  • Sensitivity and Specificity
  • Treatment Outcome
  • Ultrasonography / methods
  • Urinary Bladder Neoplasms / diagnosis*
  • Urinary Bladder Neoplasms / pathology
  • Urinary Bladder Neoplasms / surgery*
  • Urology / methods