{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,13]],"date-time":"2026-05-13T08:15:45Z","timestamp":1778660145086,"version":"3.51.4"},"reference-count":18,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2026,3,12]],"date-time":"2026-03-12T00:00:00Z","timestamp":1773273600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,3,12]],"date-time":"2026-03-12T00:00:00Z","timestamp":1773273600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["bjui-journals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJU International"],"published-print":{"date-parts":[[2026,6]]},"abstract":"\n Objective<\/jats:title>\n To develop a data\u2010driven risk\u2010stratification model to identify high\u2010risk patients following radical cystectomy (RC) for bladder cancer and propose a risk\u2010adapted follow\u2010up (FU) schedule.<\/jats:p>\n <\/jats:sec>\n \n Patients and Methods<\/jats:title>\n We performed a retrospective analysis of an individual patient data registry comprising 3196 patients with clinical T stage (cT)2\u2013T4 N0M0 bladder cancer who underwent RC at 16 European centres (1990\u20132024). All treatment decisions, including the use of neoadjuvant chemotherapy, adjuvant therapy, and the FU schedule, were made at the discretion of the treating physician in accordance with the patient's preference. A Classification and Regression Tree (CART) analysis, incorporating pathological T and N stages, lymphovascular invasion (LVI), and other features, was used to stratify patients into Low\u2010Risk and High\u2010Risk groups for recurrence. The primary endpoint was recurrence\u2010free survival (RFS). We used a landmark analysis to evaluate the conditional risk of recurrence at 1, 2, 3, 4, and 5\u2009years after RC.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n At a median FU of 81.8\u2009months, 891 patients recurred. CART analysis identified a High\u2010Risk group (pathological T stage [pT]3\u2013pT4, node\u2010positive disease, or pT2 with LVI) with significantly worse 5\u2010year RFS than the Low\u2010Risk group (37.8% vs 76.2%;\n P<\/jats:italic>\n \u2009<\u20090.001). This stratification was strongly prognostic for recurrence (hazard ratio [HR] 4.29; 95% confidence interval 3.63\u20135.00), cancer\u2010specific survival (subdistribution HR 5.80), and overall survival (HR 3.04) (all\n P<\/jats:italic>\n \u2009<\u20090.001). Landmark analysis confirmed that the elevated risk persisted up to 4\u2009years; however, the conditional risk for event\u2010free patients converged after 5\u2009years (HR 1.37;\n P<\/jats:italic>\n \u2009=\u20090.3).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n This study establishes a simple, pathologically derived model (pT3\u20134\/pN+\/pT2\u2009+\u2009LVI) that effectively stratifies post\u2010RC patients, enabling a risk\u2010adapted FU strategy. Prospective evaluation of this framework is required to confirm its clinical utility, safety, and cost\u2010effectiveness.<\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/bju.70232","type":"journal-article","created":{"date-parts":[[2026,3,13]],"date-time":"2026-03-13T05:31:11Z","timestamp":1773379871000},"page":"1058-1066","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Risk stratification and conditional recurrence after radical cystectomy: toward adaptive follow\u2010up"],"prefix":"10.1111","volume":"137","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7011-0537","authenticated-orcid":false,"given":"Roberto","family":"Contieri","sequence":"first","affiliation":[{"name":"Department of Urology Istituto Nazionale Tumori IRCCS Fondazione G. Pascale Naples Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1272-7154","authenticated-orcid":false,"given":"Alberto","family":"Martini","sequence":"additional","affiliation":[{"name":"Department of Urology University of Cincinnati College of Medicine Cincinnati OH USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8847-6799","authenticated-orcid":false,"given":"Marc","family":"Furrer","sequence":"additional","affiliation":[{"name":"Department of Urology, University Hospital of Bern University of Bern Bern Switzerland"},{"name":"Department of Urology Solothurner Spit\u00e4ler AG Olten and Solothurn Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1625-1077","authenticated-orcid":false,"given":"David","family":"D\u2019Andrea","sequence":"additional","affiliation":[{"name":"Department of Urology, Comprehensive Cancer Center Medical University of Vienna Vienna Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2812-5553","authenticated-orcid":false,"given":"Francesco","family":"Claps","sequence":"additional","affiliation":[{"name":"Oncological Urology Veneto Institute of Oncology IRCCS Padua Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Markus","family":"von Deimling","sequence":"additional","affiliation":[{"name":"Department of Urology University Medical Center Hamburg\u2010Eppendorf Hamburg Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8443-8453","authenticated-orcid":false,"given":"Francesco","family":"Soria","sequence":"additional","affiliation":[{"name":"Urology Clinic, Department of Surgical Sciences, City of Health and Sciences at Molinette University Hospital University of Turin Turin Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9070-5706","authenticated-orcid":false,"given":"Andrea","family":"Mari","sequence":"additional","affiliation":[{"name":"Unit of Oncologic Minimally Invasive Urology and Andrology Careggi Hospital, Department of Experimental and Clinical Medicine University of Florence Florence Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7321-1536","authenticated-orcid":false,"given":"Lorenzo","family":"Bianchi","sequence":"additional","affiliation":[{"name":"Division of Urology IRCCS Azienda Ospedaliero\u2010Universitaria di Bologna Bologna Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elena","family":"Tonin","sequence":"additional","affiliation":[{"name":"Division of Urology IRCCS Azienda Ospedaliero\u2010Universitaria di Bologna Bologna Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ronan","family":"Flippot","sequence":"additional","affiliation":[{"name":"Department of Cancer Medicine Gustave Roussy Villejuif France"},{"name":"Paris\u2010Saclay University Kremlin\u2010Bicetre France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9361-2342","authenticated-orcid":false,"given":"Jeremy Y. 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Lille, CNRS, Inserm, CHU Lille, Institut Pasteur de Lille UMR9020\u2010U1277 \u2013 CANTHER \u2013 Cancer Heterogeneity Plasticity and Resistance to Therapies Lille France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6628-2210","authenticated-orcid":false,"given":"Pierre\u2010Emmanuel","family":"Desprez","sequence":"additional","affiliation":[{"name":"Urology Department Claude Huriez Hospital, CHU Lille Lille France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5286-9048","authenticated-orcid":false,"given":"Renate","family":"Pichler","sequence":"additional","affiliation":[{"name":"Department of Urology, Comprehensive Cancer Centre Innsbruck Medical University of Innsbruck Innsbruck Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"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":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4176-8174","authenticated-orcid":false,"given":"Jos\u00e9 Daniel","family":"Subiela","sequence":"additional","affiliation":[{"name":"Department of Urology, Hospital Universitario Ram\u00f3n y Cajal, IRYSIS Universidad de Alcal\u00e1 Madrid Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3865-5988","authenticated-orcid":false,"given":"Francesco","family":"Del Giudice","sequence":"additional","affiliation":[{"name":"Department of Maternal Infant and Urologic Sciences Sapienza University, Umberto I Polyclinic Hospital Rome Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Valerio","family":"Santarelli","sequence":"additional","affiliation":[{"name":"Department of Maternal Infant and Urologic Sciences Sapienza University, Umberto I Polyclinic Hospital Rome Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Angelo","family":"Porreca","sequence":"additional","affiliation":[{"name":"Department of Urology Humanitas Gavazzeni Bergamo Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-2730-0402","authenticated-orcid":false,"given":"Antonio","family":"Amodeo","sequence":"additional","affiliation":[{"name":"Oncological Urology Veneto Institute of Oncology IRCCS Padua Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7355-7625","authenticated-orcid":false,"given":"Nicola","family":"Pavan","sequence":"additional","affiliation":[{"name":"Urology Clinic, Department of Precision Medicine in Medical, Surgical and Critical Care University of Palermo Palermo Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alchiede","family":"Simonato","sequence":"additional","affiliation":[{"name":"Urology Clinic, Department of Precision Medicine in Medical, Surgical and Critical Care University of Palermo Palermo Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pietro","family":"Scilipoti","sequence":"additional","affiliation":[{"name":"Division of Experimental Oncology\/Unit of Urology URI, IRCCS Ospedale San Raffaele Milan Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sisto","family":"Perdon\u00e0","sequence":"additional","affiliation":[{"name":"Department of Urology Istituto Nazionale Tumori IRCCS Fondazione G. Pascale Naples Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paolo","family":"Gontero","sequence":"additional","affiliation":[{"name":"Urology Clinic, Department of Surgical Sciences, City of Health and Sciences at Molinette University Hospital University of Turin Turin Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bas WG","family":"van Rhijn","sequence":"additional","affiliation":[{"name":"Department of Surgical Oncology (Urology) The Netherlands Cancer Institute Amsterdam The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rodolfo","family":"Hurle","sequence":"additional","affiliation":[{"name":"Department of Urology IRCCS Humanitas Research Hospital Milan Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marco","family":"Moschini","sequence":"additional","affiliation":[{"name":"Division of Experimental Oncology\/Unit of Urology URI, IRCCS Ospedale San Raffaele Milan Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Benjamin","family":"Pradere","sequence":"additional","affiliation":[{"name":"Department of Urology, UroSUd La Croix du Sud Hospital Quint\u2010Fonsegrives France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Laura S.","family":"Mertens","sequence":"additional","affiliation":[{"name":"Department of Surgical Oncology (Urology) The Netherlands Cancer Institute Amsterdam The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"name":"the European Association of Urology\u2010Young Academic Urologists (EAU\u2010YAU), Urothelial Carcinoma Working Group","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2026,3,12]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2025.02.019"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00345-006-0117-8"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2019.09.035"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2010.05.041"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.euo.2024.05.010"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.urolonc.2015.04.017"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2034442"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.urolonc.2018.03.018"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2408154"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.2217\/fon-2019-0611"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41591-023-02568-1"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.juro.2008.11.112"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.acuro.2013.01.005"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2013.54.3173"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00345-025-05992-9"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.urolonc.2021.06.009"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2007.09.008"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00345-025-05903-y"}],"container-title":["BJU International"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/bjui-journals.onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/bju.70232","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/bjui-journals.onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/bju.70232","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/bjui-journals.onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/bju.70232","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,13]],"date-time":"2026-05-13T08:00:01Z","timestamp":1778659201000},"score":1,"resource":{"primary":{"URL":"https:\/\/bjui-journals.onlinelibrary.wiley.com\/doi\/10.1111\/bju.70232"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,12]]},"references-count":18,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2026,6]]}},"alternative-id":["10.1111\/bju.70232"],"URL":"https:\/\/doi.org\/10.1111\/bju.70232","archive":["Portico"],"relation":{},"ISSN":["1464-4096","1464-410X"],"issn-type":[{"value":"1464-4096","type":"print"},{"value":"1464-410X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3,12]]},"assertion":[{"value":"2026-03-12","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}