{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T04:59:26Z","timestamp":1790830766917,"version":"4.1.0"},"reference-count":30,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Oncol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Recurrence remains common after initial transurethral resection of bladder tumor (TURBT) for non\u2013muscle-invasive bladder cancer (NMIBC). This study aimed to identify routinely available clinicopathological, treatment-related, and inflammatory factors associated with recurrence and to characterize recurrence-free survival (RFS).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      This retrospective cohort included patients with pathologically confirmed Ta, T1, or primary carcinoma\n                      <jats:italic>in situ<\/jats:italic>\n                      (CIS) who underwent initial TURBT between January 2017 and December 2023. Multivariable logistic regression was used as the primary analysis to evaluate factors associated with documented recurrence during follow-up. Cox proportional hazards regression was performed as a complementary analysis incorporating recurrence timing and censoring. Kaplan\u2013Meier analysis, sensitivity analyses, restricted cubic spline analysis, time-dependent receiver operating characteristic analysis, and bootstrap-corrected model evaluation were also performed.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 605 patients, 237 (39.2%) experienced recurrence during a median follow-up of 34.0 months. Multiple tumors were associated with higher recurrence odds and hazard (adjusted odds ratio [OR], 1.88; 95% confidence interval [CI], 1.27\u20132.78; adjusted hazard ratio [HR], 1.62; 95% CI, 1.25\u20132.10). Higher recurrence odds and hazards were also associated with increasing tumor diameter, T1 or primary CIS, high-grade pathology, concomitant CIS, and higher baseline neutrophil-to-lymphocyte ratio. Maintenance intravesical therapy was inversely associated with recurrence (adjusted OR, 0.49; 95% CI, 0.34\u20130.72; adjusted HR, 0.62; 95% CI, 0.47\u20130.81). Estimated RFS rates were 81.5%, 63.8%, and 54.1% at 1, 3, and 5 years, respectively. The bootstrap-corrected area under the curve was 0.769 for the logistic model, and the bootstrap-corrected Harrell\u2019s C-index was 0.739 for the Cox model.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Recurrence after initial TURBT was associated with greater tumor burden, adverse pathological characteristics, concomitant CIS, and higher baseline neutrophil-to-lymphocyte ratio. Maintenance intravesical therapy showed an inverse observational association with recurrence. These routinely available factors may support postoperative risk stratification and risk-adapted surveillance.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fonc.2026.1861461","type":"journal-article","created":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T04:41:51Z","timestamp":1790829711000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Risk factors for recurrence after initial transurethral resection of bladder tumor in patients with non\u2013muscle-invasive bladder cancer"],"prefix":"10.3389","volume":"16","author":[{"given":"Fang","family":"Yuan","sequence":"first","affiliation":[{"name":"Department of Urology, The Affiliated Hospital of Southwest Medical University","place":["Luzhou, Sichuan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiong","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Urology, The Affiliated Hospital of Southwest Medical University","place":["Luzhou, Sichuan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jing","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Urology, The Affiliated Hospital of Southwest Medical University","place":["Luzhou, Sichuan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jian-Yong","family":"Gao","sequence":"additional","affiliation":[{"name":"Department of Urology, Panzhihua Central Hospital","place":["Panzhihua, Sichuan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,10,1]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.5489\/cuaj.9110","article-title":"A population-based analysis of patterns of care in patients with high-risk non-muscle-invasive bladder cancer from Alberta, Canada","volume":"19","author":"Gotto","year":"2025","journal-title":"Can Urol Assoc J"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.3389\/fsurg.2023.1143219","article-title":"Transurethral resection of bladder tumor-based bladder preservation therapy for refractory high risk non-muscle invasive bladder cancer: Current landscape and future directions","volume":"10","author":"Sun","year":"2023","journal-title":"Front Surg"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1136\/bmj-2023-076743","article-title":"Advances in diagnosis and treatment of bladder cancer","volume":"384","author":"Lopez-Beltran","year":"2024","journal-title":"Bmj"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.96824","article-title":"Evaluating molecular and immune biomarkers in predicting bladder cancer recurrence and survival: A systematic review","volume":"17","author":"Masood","year":"2025","journal-title":"Cureus"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.4111\/icu.20220190","article-title":"External validation of European Association of Urology NMIBC risk scores to predict progression after transurethral resection of bladder tumor in Korean patients with non-muscle-invasive bladder cancer","volume":"63","author":"Kim","year":"2022","journal-title":"Investig Clin Urol"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.3389\/fonc.2023.1189086","article-title":"The relationship between inflammatory response markers and the prognosis of non-muscle invasive bladder cancer and the development of a nomogram model","volume":"13","author":"Yi","year":"2023","journal-title":"Front Oncol"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajcnut.2022.12.022","article-title":"Adherence to lifestyle recommendations after non-muscle invasive bladder cancer diagnosis and risk of recurrence","volume":"117","author":"van Zutphen","year":"2023","journal-title":"Am J Clin Nutr"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.1002\/cam4.6620","article-title":"Body mass index and waist circumference in relation to risk of recurrence and progression after non-muscle invasive bladder cancer","volume":"12","author":"van Zutphen","year":"2023","journal-title":"Cancer Med"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.1002\/ijc.70030","article-title":"Physical activity and risks of recurrence and progression among patients with non-muscle invasive bladder cancer","volume":"157","author":"Beeren","year":"2025","journal-title":"Int J Cancer"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.3389\/fonc.2025.1646723","article-title":"Prognostic risk factors and the role of systemic inflammatory response index in predicting outcomes for non-muscle-invasive bladder cancer","volume":"15","author":"Gui","year":"2025","journal-title":"Front Oncol"},{"key":"B11","doi-asserted-by":"publisher","first-page":"832835","DOI":"10.1016\/s2666-1683(21)00936-8","article-title":"Xpert bladder cancer monitor may avoid cystoscopies in patients under \"Active surveillance\" for recurrent bladder cancer (BIAS project): longitudinal cohort study","volume":"12","author":"Fasulo","year":"2022","journal-title":"Front Oncol"},{"key":"B12","doi-asserted-by":"publisher","first-page":"67","DOI":"10.1186\/s12894-024-01437-4","article-title":"Nomogram for customized recurrence prediction in primary non-muscle-invasive bladder cancer based on routine blood and urine parameters","volume":"24","author":"He","year":"2024","journal-title":"BMC Urol"},{"key":"B13","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2024.1467527","article-title":"Development and external validation of a model to predict recurrence in patients with non-muscle invasive bladder cancer","volume":"15","author":"Tang","year":"2024","journal-title":"Front Immunol"},{"key":"B14","doi-asserted-by":"publisher","DOI":"10.1016\/j.eclinm.2025.103125","article-title":"Deep learning-based model for prediction of early recurrence and therapy response on whole slide images in non-muscle-invasive bladder cancer: a retrospective, multicentre study","volume":"81","author":"Jiang","year":"2025","journal-title":"EClinicalMedicine"},{"key":"B15","doi-asserted-by":"publisher","DOI":"10.1002\/path.6153","article-title":"Application of digital pathology-based advanced analytics of tumour microenvironment organisation to predict prognosis and therapeutic response","volume":"260","author":"Fu","year":"2023","journal-title":"J Pathol"},{"key":"B16","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpi.2025.100542","article-title":"Applications and challenges of utilizing digital pathology and AI-enabled workflows in clinical trials","volume":"20","author":"Sebastian","year":"2026","journal-title":"J Pathol Inform"},{"key":"B17","doi-asserted-by":"publisher","DOI":"10.2147\/jir.s529335","article-title":"Integrating pre- and postoperative systemic inflammatory markers for acute kidney injury prediction following radical cystectomy: A multi-center retrospective study","volume":"18","author":"Liu","year":"2025","journal-title":"J Inflammation Res"},{"key":"B18","doi-asserted-by":"publisher","DOI":"10.3389\/fonc.2025.1696383","article-title":"The impact of body composition and systemic inflammatory markers on postoperative complications in early-stage cervical cancer","volume":"15","author":"Ding","year":"2025","journal-title":"Front Oncol"},{"key":"B19","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2024.07.027","article-title":"European association of urology guidelines on non-muscle-invasive bladder cancer (TaT1 and carcinoma in situ)-A summary of the 2024 guidelines update","volume":"86","author":"Gontero","year":"2024","journal-title":"Eur Urol"},{"key":"B20","doi-asserted-by":"publisher","DOI":"10.3390\/biophysica6030041","article-title":"Assessing the effects of photodynamic therapy with exogenous PpIX and Rose Bengal in an ex vivo non-muscle-invasive bladder cancer low-grade pTa model","volume":"6","author":"Godlewski","year":"2026","journal-title":"Biophysica"},{"key":"B21","doi-asserted-by":"publisher","DOI":"10.3389\/fsurg.2024.1489832","article-title":"Association between tumor size and prognosis in bladder cancer: Novel classifications and insights from a SEER database analysis","volume":"11","author":"Jia","year":"2024","journal-title":"Front Surg"},{"key":"B22","doi-asserted-by":"publisher","DOI":"10.3390\/cancers18101651","article-title":"Circulating tumor DNA in upper tract urothelial carcinoma: A framework for precision perioperative management","volume":"18","author":"Prakash","year":"2026","journal-title":"Cancers"},{"key":"B23","doi-asserted-by":"publisher","DOI":"10.3322\/caac.70019","article-title":"Urothelial carcinoma: Perioperative considerations from top to bottom","volume":"75","author":"Yip","year":"2025","journal-title":"CA Cancer J Clin"},{"key":"B24","doi-asserted-by":"publisher","first-page":"247","DOI":"10.1186\/s12894-025-01926-0","article-title":"Analysis of risk factors for postoperative bladder cancer in patients with upper tract urothelial carcinoma and construction of nomogram prediction model","volume":"25","author":"Li","year":"2025","journal-title":"BMC Urol"},{"key":"B25","doi-asserted-by":"publisher","first-page":"667","DOI":"10.1038\/s41598-025-21188-y","article-title":"Elevated neutrophil-to-lymphocyte ratio and the incidence of autoimmune diseases: Evidence from a large prospective cohort study","volume":"16","author":"Yoon","year":"2026","journal-title":"Sci Rep"},{"key":"B26","doi-asserted-by":"publisher","first-page":"64","DOI":"10.1016\/j.euros.2021.01.015","article-title":"Long-term follow-up after en bloc transurethral resection of non-muscle-invasive bladder cancer: Results from a single-center experience","volume":"26","author":"Paciotti","year":"2021","journal-title":"Eur Urol Open Sci"},{"key":"B27","doi-asserted-by":"publisher","DOI":"10.1159\/000533410","article-title":"Analysis of risk factors for recurrence after transurethral resection of bladder tumor in patients with non-muscle invasive bladder cancer: 2-year follow-up outcomes","volume":"102","author":"Li","year":"2024","journal-title":"Oncology"},{"key":"B28","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2024.1464635","article-title":"Prognostic value of neutrophil-to-lymphocyte ratio in patients with non-muscle-invasive bladder cancer with intravesical Bacillus Calmette-Gu\u00e9rin immunotherapy: A systematic review and meta-analysis","volume":"15","author":"Huang","year":"2024","journal-title":"Front Immunol"},{"key":"B29","doi-asserted-by":"publisher","DOI":"10.1016\/j.euf.2025.04.033","article-title":"Long-term oncological outcomes for patients with non-muscle-invasive bladder cancer treated with Bacillus Calmette-Gu\u00e9rin (BCG): A comparative analysis of adequate versus inadequate BCG treatment","volume":"12","author":"Scilipoti","year":"2026","journal-title":"Eur Urol Focus"},{"key":"B30","doi-asserted-by":"publisher","first-page":"480","DOI":"10.1007\/s00345-024-05192-x","article-title":"Prognostic significance of residual tumor at restaging transurethral bladder resection in high-risk non-muscle-invasive bladder cancer","volume":"42","author":"Guigui","year":"2024","journal-title":"World J Urol"}],"container-title":["Frontiers in Oncology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fonc.2026.1861461\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T04:41:56Z","timestamp":1790829716000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fonc.2026.1861461\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10,1]]},"references-count":30,"alternative-id":["10.3389\/fonc.2026.1861461"],"URL":"https:\/\/doi.org\/10.3389\/fonc.2026.1861461","relation":{},"ISSN":["2234-943X"],"issn-type":[{"value":"2234-943X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10,1]]},"article-number":"1861461"}}