AccScience Publishing / Bladder / Online First / DOI: 10.14440/bladder.0039
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RESEARCH ARTICLE

Real-world management of T1 high-grade bladder cancer: A 14-year retrospective single-center study

Zexuan Lv1,2,3† ,  Yi Feng1,2,4† ,  Bingyang Guo1,2,4† ,  Bin Jiang1,2,3 ,  Hongyu Zhang1,2,3 ,  Yin Lu1,2,3 ,  Wenfeng Gao1,2,3 ,  Jinlu Tang1,2,4 ,  Qing Ai1,2 ,  Qiang Cheng1,2,4* ,  Hongzhao Li1,2*
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1 Department of Urology, The Third Medical Center, People’s Liberation Army General Hospital, Beijing 100039, China
2 Department of Urology, Chinese People’s Liberation Army General Hospital, Beijing 100039, China
3 School of Medicine, Nankai University, Tianjin 300071, China
4 Chinese People’s Liberation Army Medical School, Beijing 100853, China
Bladder 2025, 12(4), e21200060 https://doi.org/10.14440/bladder.0039
Submitted: 15 April 2025 | Revised: 9 July 2025 | Accepted: 11 July 2025 | Published: 22 August 2025
© 2025 by the Author(s). This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution -Noncommercial 4.0 International License (CC-by the license) ( https://creativecommons.org/licenses/by-nc/4.0/ )
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Abstract

Background: T1 high-grade (T1HG) bladder cancer (BC) carries substantial risks of recurrence and progression, deserving of heightened clinical attention. Objective: The present study evaluated the management approaches and reported 14-year real-world outcomes in patients with T1HG BC from a single-center cohort. Methods: Data were retrospectively collected from primary T1HG patients who had undergone transurethral resection of bladder tumors (TURBT) at our institution between 2010 and 2023. A total of 165 patients were included. Their baseline characteristics, pathological findings, adjuvant therapies, recurrence, progression, and survival outcomes were analyzed. Predictors of tumor recurrence were modeled using multivariable analyses. Results: Tumor recurrence was significantly associated with post-operative Bacillus Calmette–Guérin (BCG) treatment (odds ratio [OR]: 0.315, p=0.001) and tumor multifocality (OR: 0.476, p=0.033). Among patients having received post-operative BCG treatment, tumor recurrence bore a significant correlation with tumor multifocality (OR: 0.328, p=0.027), and elevated body mass index (BMI) was identified as a potential accelerator of recurrence (hazard ratio: 1.098, p=0.01). The 10-year recurrence-free survival rate among all patients stood at 54.9% (95% confidence interval [CI]: 44.3–65.5%), with a median of 134 months (95% CI: 64.7–203.3 months). The rate of re-TURBT was 20%. The 10-year progression-free survival was 87.2% (95% CI: 81.0–93.5%) and the 10-year overall survival was 66.7% (95% CI: 54.0–79.4%). The 10-year cancer-specific survival and the 10-year cystectomy-free survival (CFS) rates were 93.7% (95% CI: 88.4–99.0%) and 86.3% (95% CI: 79.8–92.8%), respectively. Notably, BCG treatment significantly improved CFS (p=0.01). Conclusion: Recurrence in T1HG disease is associated with BCG therapy and tumor multifocality, with a high BMI potentially promoting relapse.

Keywords
Non-muscle invasive bladder cancer
Bladder preservation
Cystectomy
Bacillus Calmette–Guérin treatment
Tumor recurrence
Funding
This work was supported by the National Key R and D Program of China (No. 2023YFC2507006 and No. 2022YFC3602900) and the Central Health Research Project (The project number 2024YB14).
Conflict of interest
The authors declare no conflict of interest.
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Bladder, Electronic ISSN: 2327-2120 Print ISSN: TBA, Published by POL Scientific
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