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    Better models needed for predicting bladder Ca recurrence


    The big three take-home points from the study, according to Dr. Downs, are: All three models were best at predicting recurrence and progression in low-risk bladder cancer patients. All three models overestimated the cancer progressing to a higher stage in high-risk individuals. And all three models were not very good at predicting recurrence in the growing body of patients who receive bacillus Calmette-Guérin therapy.

    “In our highest risk patients, where we want to be even more accurate, that’s where these models are not very good. Yet, these models perform better in our low-risk patients,” Dr. Downs said.

    Dr. Downs said he believes that, even though these models have some limitations, their use should not be disregarded.

    “I use them as a starting point for conversations with patients and with other colleagues,” he said.

    Read: Bladder Ca photothermal treatment yields encouraging results

    One example: The EORTC model has a risk calculator application that urologists can download on their smartphones. They can plug in a patient’s age, cancer grade, and number of tumors, and the app will calculate the information in terms of the percentage of patients who will recur in a given time frame and who will progress, according to Dr. Downs.

    “What I have found helpful in the management of nonmuscle-invasive bladder cancer patients, is to step back and ask yourself a few simple questions: Are we managing the patient to prevent the cancer from coming back (ie, recurrence)? Or are we managing the patient’s cancer from progressing?” Dr. Downs said.

    Being able to share this information with the patient is very powerful, because when they hear the word “cancer,” most patients think of the most aggressive form of a cancer that can lead to death, according to Dr. Downs.

    “In many instances, for patients diagnosed with low-risk or intermediate-risk bladder cancer, we are managing the risk of the cancer recurring. When making treatment recommendations for a patient with low-risk nonmuscle-invasive bladder cancer in the clinic, I can share that we are managing the frequency of the cancer coming back or eliminating it from coming back altogether. But this isn’t one that’s going to spread and become lethal,” he said. “That’s how I use these tools—as starting points.”

    More from Urology Times:

    Smoking linked to tumor heterogeneity for bladder Ca

    Investigational BCG-refractory NMIBC Tx shows promise

    Genomic research may explain resistance to immunotherapy

    To get weekly news from the leading news source for urologists, subscribe to the Urology Times eNews.

    Lisette Hilton
    Lisette Hilton, president of Words Come Alive, has written about health care, the science and business of medicine, fitness and wellness ...


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