EORTC Bladder Cancer Recurrence and Progression Calculator

Bladder cancer is the most common urinary tract malignancy. It usually affects people over 60 years old and more men than women. Smoking is the biggest risk factor for developing this cancer (smoking, of course, also increases your lung cancer risk – see the lung cancer risk calculator — and kidney cancer risk). The most typical symptom is painless hematuria (blood in the urine). Remember! If haematuria has been found, always search for bladder (or kidney) cancer!

At the time of diagnosis, around 75% of the 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. Still, the condition has a significant potential for recurrence of the tumor in the bladder, which may even progress into a more advanced stage of the disease.

The treatment of patients with non-muscle invasive bladder cancer should be based on their prognosis, which includes a prediction of the tumor's recurrence and progression. This EORTC bladder cancer recurrence and progression calculator is a tool that predicts the probability of recurrence and progression and thus proposes appropriate management of patients with non-muscle invasive bladder cancer.

This calculator was built using the recommendations set out by the European Association of Urology in their guidelines on non-muscle invasive bladder cancer. This process was first described using the analysis of almost 2600 patients by Sylvester et al. in an article titled Predicting recurrence and progression in individual patients with stage Ta T1 bladder cancer using EORTC risk tables. This bladder cancer prognosis calculator is a kind of scoring system which is based on six clinical and pathological factors:

• Number of tumors;
• Tumor size (diameter of the biggest tumor);
• Prior bladder cancer recurrence rate;
• Stage of the disease (T category);
• Carcinoma in situ (in bladder cancer, CIS is always high grade, requires immediate treatment, and worsens the prognosis); and
• Tumor grade.

For each of these variables, the patient receives a score from 0 to 6 (for both the risk of recurrence and progression). The details are presented in the table:

After calculating the recurrence points and progression points, they are transferred into percentages of risk according to the tables below:

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 attached to a specific patient, the urologist can discuss the different therapeutic options with the patient to determine the most appropriate treatment and the frequency of follow-up required.

Was this calculator helpful? If you are interested in oncology, check out the following calculators:

• ANC calculator, which helps you determine the risk of febrile neutropenia in patients undergoing chemotherapy; and
• Breast cancer recurrence risk calculator.