Patients with NMIBC frequently experience recurrences. Yet, the timing and characteristics of subsequent recurrences are understudied. We aim to describe subsequent recurrences in a large, contemporary, population-based cohort.
We included 1915 patients from the UroLife study and the Nijmegen Bladder Cancer Study, diagnosed with primary NMIBC between 2011 and 2021. The conditional 1-, 3- and 5-year risks of first to fourth recurrence were calculated using Kaplan-Meier risks, stratified by clinicopathological factors. Patterns of subsequent tumors were described and visualized.
We observed 671 first recurrences and 400 subsequent recurrences. The 3-year conditional recurrence risks for first, second and third recurrence were 31%, 45%, and 54%, respectively, and were similar for NMIBC risk groups. Recurrence after a low-, intermediate- or high-risk tumor (either primary or recurrent) was again of low-, intermediate- or high-risk in 74%, 62% and 44% of cases, respectively. Ten patients with low/intermediate-risk NMIBC and 89 patients with high-risk NMIBC progressed to MIBC or mBC. Seven out of these ten (70%) and 13 out of these 89 (15%) patients had a high-risk recurrence before progression. This study was limited to a patient cohort from The Netherlands.
Our study provides reliable estimates of recurrence rates and patterns in NMIBC from a large, contemporary, population-based cohort. Recurring NMIBC tumors often exhibit similar clinicopathological characteristics, and patients with primary low- or intermediate-risk NMIBC that progresses to MIBC/mBC often have a high-risk recurrence before progression. These results can inform research into NMIBC recurrences and surveillance schedules.
Clinical genitourinary cancer. 2025 Nov 04 [Epub ahead of print]
Jasper P Hof, Lambertus A L M Kiemeney, Katja K H Aben, Antoine G van der Heijden, Alina Vrieling, Sita H Vermeulen
IQ Health Science Department, Radboud University Medical Center, PO Box 9101, 6500GB, Nijmegen, the Netherlands., IQ Health Science Department, Radboud University Medical Center, PO Box 9101, 6500GB, Nijmegen, the Netherlands; Department of Urology, Radboud University Medical Center, PO Box 9101, 6500GB, Nijmegen, the Netherlands., IQ Health Science Department, Radboud University Medical Center, PO Box 9101, 6500GB, Nijmegen, the Netherlands; Department of Research and Development, Netherlands Comprehensive Cancer Organization, PO Box 19079, 3501DB, Utrecht, the Netherlands., Department of Urology, Radboud University Medical Center, PO Box 9101, 6500GB, Nijmegen, the Netherlands., IQ Health Science Department, Radboud University Medical Center, PO Box 9101, 6500GB, Nijmegen, the Netherlands. Electronic address: .