{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T13:07:47Z","timestamp":1790946467435,"version":"4.1.0"},"reference-count":35,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2025,5,21]],"date-time":"2025-05-21T00:00:00Z","timestamp":1747785600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bjui-journals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJU International"],"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To report real\u2010world rates of non\u2010muscle\u2010invasive bladder cancer (NMIBC) recurrence and progression within a European multicentre cohort with detailed information on intravesical instillation courses, as contemporary data on oncological outcomes in NMIBC are limited.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patients and methods<\/jats:title>\n                    <jats:p>A total of 1918 patients with NMIBC treated with transurethral resection of bladder tumour (TURBT) were retrospectively identified from six tertiary\u2010referral European centres (2015\u20132022). Patients were stratified according to European Association of Urology 2021 criteria into low\u2010 (LR), intermediate\u2010 (IR), high\u2010 (HR) and very high\u2010risk (VHR) categories. Cumulative incidence plots and multivariable competing risks regression models addressing 5\u2010year rates of high\u2010grade (HG) recurrence and progression were fitted. Sensitivity analyses focused on patients receiving intravesical instillations and tested for the effect of adequate course (Bacillus Calmette\u2010Gu\u00e9rin: five or more induction + two or more maintenance instillations; mitomycin C: complete induction + \u226511 maintenance instillations).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Of all NMIBC patients identified, 467 (24.3%) were\u00a0LR vs 582 (30.3%) IR vs 739 (38.5%) HR vs 130 (6.8%) VHR. The median (interquartile range) follow\u2010up after TURBT was 26\u2009(12\u201346)\u2009months. The 5\u2010year HG recurrence rates were 7.2% in LR vs 17.3% in IR vs 26.7% in HR vs 30.9% in VHR patients, resulting in a three\u2010, five\u2010 and seven\u2010fold higher risk of IR, HR and VHR, respectively, relative to LR (all\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.001). The 5\u2010year progression rates were 3.9% in LR vs 5.2% in IR vs 13.6% in HR vs 31.6% in VHR patients, resulting in a six\u2010 and nine\u2010fold higher risk for HR and VHR, respectively, relative to LR (all\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.001). In all, 1001 (52.2%) patients underwent intravesical instillations. Those receiving adequate instillation course (244\/1001 [24.3%]) had lower HG\u2010recurrence (hazard ratio 0.3,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.001) and progression (hazard ratio 0.2,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.001) risk.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Patients with HR\/VHR NMIBC face significantly higher HG recurrence and progression risks. While tailored treatment strategies are needed, adherence to adequate instillation course remains crucial for optimising oncological outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/bju.16780","type":"journal-article","created":{"date-parts":[[2025,5,22]],"date-time":"2025-05-22T01:34:47Z","timestamp":1747877687000},"page":"826-834","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":28,"title":["Contemporary outcomes in non\u2010muscle\u2010invasive bladder cancer: a large European multicentre study"],"prefix":"10.1111","volume":"136","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2613-2306","authenticated-orcid":false,"given":"Mattia","family":"Longoni","sequence":"first","affiliation":[{"name":"Department of Experimental Oncology\/Unit of Urology URI, IRCCS Ospedale San Raffaele  Milan Italy"},{"name":"Vita\u2010Salute San Raffaele University  Milan Italy"},{"name":"Cancer Prognostics and Health Outcomes Unit, Division of Urology University of Montr\u00e9al Health Centre  Montr\u00e9al Qu\u00e9bec Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pietro","family":"Scilipoti","sequence":"additional","affiliation":[{"name":"Department of Experimental Oncology\/Unit of Urology URI, IRCCS Ospedale San Raffaele  Milan Italy"},{"name":"Vita\u2010Salute San Raffaele University  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-0494-7839","authenticated-orcid":false,"given":"Mario","family":"De Angelis","sequence":"additional","affiliation":[{"name":"Department of Experimental Oncology\/Unit of Urology URI, IRCCS Ospedale San Raffaele  Milan Italy"},{"name":"Vita\u2010Salute San Raffaele University  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paolo","family":"Zaurito","sequence":"additional","affiliation":[{"name":"Department of Experimental Oncology\/Unit of Urology URI, IRCCS Ospedale San Raffaele  Milan Italy"},{"name":"Vita\u2010Salute San Raffaele University  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-9363-682X","authenticated-orcid":false,"given":"Giovanni","family":"Tremolada","sequence":"additional","affiliation":[{"name":"Department of Experimental Oncology\/Unit of Urology URI, IRCCS Ospedale San Raffaele  Milan Italy"},{"name":"Vita\u2010Salute San Raffaele University  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alfonso","family":"Santangelo","sequence":"additional","affiliation":[{"name":"Department of Experimental Oncology\/Unit of Urology URI, IRCCS Ospedale San Raffaele  Milan Italy"},{"name":"Vita\u2010Salute San Raffaele University  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4868-9025","authenticated-orcid":false,"given":"Giuseppe","family":"Simone","sequence":"additional","affiliation":[{"name":"Department of Urology IRCCS \u2018Regina Elena\u2019 National Cancer Institute  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3708-2209","authenticated-orcid":false,"given":"Riccardo","family":"Mastroianni","sequence":"additional","affiliation":[{"name":"Department of Urology IRCCS \u2018Regina Elena\u2019 National Cancer Institute  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0113-9920","authenticated-orcid":false,"given":"Chiara","family":"Lonati","sequence":"additional","affiliation":[{"name":"Urology Unit, ASST Spedali Civili di Brescia, Department of Medical and Surgical Specialties, Radiological Science and Public Health University of Brescia  Brescia Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6244-4120","authenticated-orcid":false,"given":"Stefania","family":"Zamboni","sequence":"additional","affiliation":[{"name":"Urology Unit, ASST Spedali Civili di Brescia, Department of Medical and Surgical Specialties, Radiological Science and Public Health University of Brescia  Brescia Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nazareno","family":"Suardi","sequence":"additional","affiliation":[{"name":"Urology Unit, ASST Spedali Civili di Brescia, Department of Medical and Surgical Specialties, Radiological Science and Public Health University of Brescia  Brescia Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gautier","family":"Marcq","sequence":"additional","affiliation":[{"name":"Department of Urology Claude Huriez Hospital  Lille 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of Alcal\u00e1  Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pedro Del Olmo","family":"Dur\u00e1n","sequence":"additional","affiliation":[{"name":"Department of Urology, Ram\u00f3n y Cajal University Hospital, IRYCIS University of Alcal\u00e1  Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4344-0191","authenticated-orcid":false,"given":"Aleksander","family":"\u015alusarczyk","sequence":"additional","affiliation":[{"name":"Department of General, Oncological and Functional Urology Medical University of Warsaw  Warsaw Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pierre I.","family":"Karakiewicz","sequence":"additional","affiliation":[{"name":"Cancer Prognostics and Health Outcomes Unit, Division of Urology University of Montr\u00e9al Health Centre  Montr\u00e9al Qu\u00e9bec Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benjamin","family":"Pradere","sequence":"additional","affiliation":[{"name":"Department of Urology, UROSUD La Croix du Sud Hospital  Quint Fonsegrives France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8443-8453","authenticated-orcid":false,"given":"Francesco","family":"Soria","sequence":"additional","affiliation":[{"name":"Division of Urology, Department of Surgical Sciences, San Giovanni Battista Hospital University of Studies of Torino  Turin Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paolo","family":"Gontero","sequence":"additional","affiliation":[{"name":"Division of Urology, Department of Surgical Sciences, San Giovanni Battista Hospital University of Studies of Torino  Turin Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Morgan","family":"Roupr\u00eat","sequence":"additional","affiliation":[{"name":"Urology, GRC no. 5, Predictive Onco\u2010Urology, H\u00f4pital Piti\u00e9\u2010Salp\u00eatri\u00e8re, AP\u2010HP Sorbonne Universit\u00e9  Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7267-4181","authenticated-orcid":false,"given":"Francesco","family":"Montorsi","sequence":"additional","affiliation":[{"name":"Department of Experimental Oncology\/Unit of Urology URI, IRCCS Ospedale San Raffaele  Milan Italy"},{"name":"Vita\u2010Salute San Raffaele University  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0595-7165","authenticated-orcid":false,"given":"Andrea","family":"Salonia","sequence":"additional","affiliation":[{"name":"Department of Experimental Oncology\/Unit of Urology URI, IRCCS Ospedale San Raffaele  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