Coexistence of low-grade component predicts better prognosis in patients with primary, solitary high-grade non-muscle invasive bladder cancer

Abstract

Abstract Background To determine the impact of coexisted low-grade components on the prognosis of high-grade non-muscle-invasive bladder cancer (NMIBC). Method A total of 167 patients with a mean follow-up of 39.32 months underwent transurethral resection of primary, solitary non-muscle invasive bladder tumor between January 2010 and December 2019, including 35 patients with coexisted low-grade components and 132 patients with pure high-grade tumors. All patients underwent adequate intravesical chemotherapy. Result Baseline characteristics were well balanced between patients with pure high-grade tumor and those with coexisted low-grade components. Five-year recurrence-free survival was much worse for pure high-grade tumor compared to high-grade tumor with coexisted low-grade component (50.5% vs 80.0%, p = 0.01). Multivariable cox regression analysis revealed coexisted low-grade components to be an independent risk factor for recurrence (hazard ratio = 2.34, p = 0.02). Other significant contributing factor was T1 stage (hazard ratio = 2.09, p = 0.01). Conclusion Coexistence of low-grade component predicts better prognosis in patients with primary, solitary high-grade non-muscle invasive bladder cancer.