EORTC Bladder Cancer Recurrence & Progression Calculator
Predict the probability of recurrence and progression in patients with non-muscle invasive bladder cancer (NMIBC) using the EORTC scoring system.
About Bladder Cancer
Bladder cancer is the most common urinary tract malignancy. It usually affects people over 60 years old and is more common in men than women. Smoking is the biggest risk factor for developing bladder cancer. The most typical symptom is painless hematuria (blood in the urine).
At the time of diagnosis, approximately 75% of patients have non-muscle invasive bladder cancer (NMIBC), while the remaining 25% already have advanced disease. Patients with NMIBC generally have a good survival rate, but the condition has significant potential for recurrence and may even progress into a more advanced stage.
Bladder Cancer Recurrence & Progression Calculator
Treatment of patients with NMIBC should be based on their prognosis, which includes predictions of tumor recurrence and progression. This calculator was built using recommendations from the European Association of Urology (EAU) guidelines, based on analysis of almost 2,600 patients by Sylvester et al.
Scoring System
The EORTC scoring system evaluates six clinical and pathological factors:
| Factor | Value | Recurrence Points | Progression Points |
|---|---|---|---|
| Number of Tumors | Single | 0 | 0 |
| 2-7 | 3 | 3 | |
| ≥ 8 | 6 | 3 | |
| Tumor Diameter | < 3 cm | 0 | 0 |
| ≥ 3 cm | 3 | 3 | |
| Prior Recurrence Rate | Primary | 0 | 0 |
| ≤ 1 rec/year | 2 | 2 | |
| > 1 rec/year | 4 | 2 | |
| Stage | Ta | 0 | 0 |
| T1 | 1 | 4 | |
| Concomitant CIS | No | 0 | 0 |
| Yes | 1 | 6 | |
| Grade | G1 | 0 | 0 |
| G2 | 1 | 0 | |
| G3 | 2 | 5 | |
| Total Score Range | 0 – 17 | 0 – 23 | |
Risk Probability Tables
Recurrence Risk
| Recurrence Score | 1-Year Risk | 5-Year Risk |
|---|---|---|
| 0 | 15% | 31% |
| 1 – 4 | 24% | 46% |
| 5 – 9 | 38% | 62% |
| 10 – 17 | 61% | 78% |
Progression Risk
| Progression Score | 1-Year Risk | 5-Year Risk |
|---|---|---|
| 0 | 0.2% | 0.8% |
| 2 – 6 | 1% | 6% |
| 7 – 13 | 5% | 17% |
| 14 – 23 | 17% | 45% |
Interpreting the Results
The probabilities of recurrence and progression at one year range from 15% to 61% and from less than 1% to 17%, respectively. At the five-year mark, the probabilities of recurrence and progression range from 31% to 78% and from less than 1% to 45%.
Using the data specific to a patient, the urologist can discuss different therapeutic options and determine the most appropriate treatment and follow-up frequency.
Frequently Asked Questions
What is non-muscle invasive bladder cancer (NMIBC)?
NMIBC is bladder cancer that hasn't invaded the muscle layer of the bladder wall. It accounts for about 75% of bladder cancer diagnoses and includes stages Ta (papillary, confined to mucosa) and T1 (invading subepithelial connective tissue). While it has good survival rates, NMIBC has a high recurrence rate.
What is Carcinoma in Situ (CIS)?
CIS is a flat, high-grade urothelial carcinoma that is confined to the urothelial lining. In bladder cancer, CIS is always high grade, requires immediate treatment, and significantly worsens the prognosis. It adds 1 recurrence point and 6 progression points to the EORTC score.
Who developed this scoring system?
The EORTC scoring system was developed based on analysis of almost 2,600 patients by Sylvester et al. and adopted by the European Association of Urology in their guidelines for NMIBC management. The study was published in the article "Predicting recurrence and progression in individual patients with stage Ta T1 bladder cancer using EORTC risk tables."
What is the biggest risk factor for bladder cancer?
Smoking is the biggest risk factor for developing bladder cancer. It also increases lung cancer and kidney cancer risk. Other risk factors include occupational exposure to certain chemicals, chronic bladder infections, and certain medications.