EORTC Bladder Cancer Recurrence and Progression

Evaluates recurrence and progression of a non-muscle invasive bladder malignancy over one and five years.

Refer to the text below the calculator for more information about the EORTC items and scoring the recurrence and progression results.


Patients with non-muscle invasive bladder cancer (NMIBC) may have a significant potential for recurrence of the tumor in the bladder, and of progression to advanced stages.

The European Organization for Research and Treatment of Cancer (EORTC) has set out in 2006 guidelines on the appropriate management of NMIBC and has provided EORTC risk scoring tables with 6 items to be evaluated and the 1-year, respectively 5-year, recurrence and progression risks.


The recurrence and progression total scores of the 6 EORTC clinical and pathological items are translated into 1-year and 5-year recurrence and progression risks:

Recurrence Score Interpretation

Recurrence points 1-year recurrence risk 5-year recurrence risk
0 15% 31%
1 – 4 24% 46%
5 – 9 38% 62%
10 – 17 61% 78%

Progression Score Interpretation

Progression points 1-year progression risk 5-year progression risk
0 0.2% 0.8%
2 – 6 1% 6%
7 – 13 5% 17%
14 – 23 17% 45%

1

Number of tumors

2

Tumor size

3

Prior recurrence rate

4

T category

5

Carcinoma in situ

6

Grade

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EORTC Bladder Cancer Recurrence and Progression

Patients with non-muscle invasive bladder cancer (NMIBC) may have a significant potential for recurrence of the tumor in the bladder, and of progression to advanced stages.

The European Organization for Research and Treatment of Cancer (EORTC) has set out in 2006 guidelines on the appropriate management of NMIBC and has provided EORTC risk scoring tables with 6 items to be evaluated and the 1-year, respectively 5-year, recurrence and progression risks.

Score items Answer choices Recurrence scoring Progression scoring
Number of tumors Single 0 0
2 to 7 3 3
≥8 6 3
Tumor size <3 cm 0 0
≥3 cm 3 3
Prior recurrence rate Primary 0 0
≤1 rec/year 2 2
>1 rec/year 4 2
T category Ta 0 0
T1 1 4
Carcinoma in situ No 0 0
Yes 1 6
Grade G1 0 0
G2 1 0
G3 2 5

The recurrence total score of the 6 EORTC clinical and pathological items is translated into 1-year and 5-year recurrence risks:

Recurrence points 1-year recurrence risk 5-year recurrence risk
0 15% 31%
1 – 4 24% 46%
5 – 9 38% 62%
10 – 17 61% 78%

The progression total score of the 6 EORTC items is translated into 1-year and 5-year progression risks:

Progression points 1-year progression risk 5-year progression risk
0 0.2% 0.8%
2 – 6 1% 6%
7 – 13 5% 17%
14 – 23 17% 45%

The above recurrence and progression percentages can be used by clinicians to discuss with the patient their options and the most appropriate treatment means.

Please note that the model does not benefit from excellent validation. For example, in a study by Xylinas et al. the model showed poor discrimination with C-statistics between 0.597 - 0.662.

 

References

Original reference

Sylvester RJ, van der Meijden AP, Oosterlinck W, et al. Predicting recurrence and progression in individual patients with stage Ta T1 bladder cancer using EORTC risk tables: a combined analysis of 2596 patients from seven EORTC trials. Eur Urol. 2006; 49(3):466-477.

Validation

Leo MC, McMullen CK, O'Keeffe-Rosetti M, Weinmann S, Garg T, Nielsen ME. External validation of the EORTC and NCCN bladder cancer recurrence and progression risk calculators in a U.S. community-based health system. Urol Oncol. 2020; 38(2):39.e21-39.e27.

Xylinas E, Kent M, Kluth L, Pycha A, Comploj E, Svatek RS, Lotan Y, Trinh QD, Karakiewicz PI, Holmang S, Scherr DS, Zerbib M, Vickers AJ, Shariat SF. Accuracy of the EORTC risk tables and of the CUETO scoring model to predict outcomes in non-muscle-invasive urothelial carcinoma of the bladder. Br J Cancer. 2013; 109(6):1460-6.

Other references

Borkowska EM, Jędrzejczyk A, Marks P, Catto JW, Kałużewski B. EORTC risk tables - their usefulness in the assessment of recurrence and progression risk in non-muscle-invasive bladder cancer in Polish patients. Cent European J Urol. 2013; 66(1):14-20.


Specialty: Oncology

System: Urinary

Year Of Study: 2006

Abbreviation: EORTC

Article By: Denise Nedea

Published On: August 1, 2020

Last Checked: August 1, 2020

Next Review: August 1, 2025