The effect of clinical and pathological parameters on prognosis for high grade bladder tumor patients with submucosal invasion

Purpose: Patients diagnosed with bladder urethelial carcinoma are NMIBC with %75 rate at the beginning. It is observed that more than %70 of NMIBC patients have recurrence in time and more than %10 will have T2 progression. In this study, we aimed at investigating the effect of demographic, clinical and pathological parameters on prognosis in NMIBC. Method and materials: Patients with bladder T1G3 urethelial carcinoma pathology are assessed retrospectively, who have been treated in our hospital in between 2006-2018. The data spectrum of the patients according to key aspects are; demography: age, sex; clinical: tumor size, number of tumors and NLR; pathology: submucosal invasion depth, existence of concurrent CIS, existence of concurrent LVI and existence of variant histology. The statistical correlation between these variations and a number of prognostic factors in NMIBC is analyzed. Findings: 63 out of 153 patients with T1G3 pathological diagnosis did not meet the pre-determined criteria, hence excluded. Out of the patients included in the study, 61 were primary and 33 secondary. Median length of follow-up was 36.5 (2-150) months. We had 80 male (85.1%) and 14 female (14.9%) patients (p< 0.05). Average age was 64.6±9.4 for male and 68.1±12.3 for female (p> 0.05) with an overall average age of 65.2±9.9. 47 patients (50%) had recurrence and 27 (28.7%) had progression. Average period of time until recurrence and progression was 9±4 (1-83) and 17.1±2 (2-70) months respectively. Overall survival period was 92.2±8.0 months. In terms of recurrence and progression probability, the effects of tumor size (p= 0.039), number of tumors (p= 0.022), NLR (p= 0.048) and existence of concurrent LVI (p= 0.011) were statistically significant. Period of time until recurrence or progression was not correlated with any of the parameters in the study (p>0.05). Overall survival was only correlated with NLR (p= 0.048). Result: It has been found out that, tumor size, number of tumors, NLR and LVI has prognostic consequences in NMIBC patients. The lack of correlation between other parameters and prognostic factors might be due to the retrospective nature of the study, low number of patients, heterogeneity in patient groups and finally the existence of early cystectomy patients in our sample set. Keywords: Bladder cancer, recurrence, progression.