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Predicting the Risk of High-Grade Bladder Cancer Using Noninvasive Data

Shapur N.a · Pode D.a · Katz R.a · Shapiro A.a · Yutkin V.a · Pizov G.a · Appelbaum L.a · Zorn K.C.b · Duvdevani M.a · Landau E.H.a · Gofrit O.N.a
aDepartments of Urology, Pathology and Radiology, Hadassah Hebrew University Hospital, Jerusalem, Israel; bSection of Urology, Department of Surgery, Chicago University of Chicago Medical Center, Chicago, Ill., USA Urol Int 2011;87:319–324 (DOI:10.1159/000328635)


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.


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