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Background <p>We aimed to evaluate the impact of bladder tumor location on oncological outcomes in high-grade non-muscle-invasive bladder cancer (NMIBC).</p> Patients and Methods <p>The testing cohort included 1796 patients with high-grade NMIBC treated with transurethral resection of bladder tumor (TURBT) and adjuvant Bacillus Calmette–Guérin (BCG). The primary endpoints were high-grade recurrence-free survival (HG-RFS) and progression-free survival (PFS). Propensity score matching (PSM) was used to adjust for clinicopathological confounders between patients with and without trigone/bladder neck involvement. External validation included 20,249 high-grade NMIBC from the Surveillance, Epidemiology, and End Results (SEER) database, with overall and cancer-specific survival (CSS) as endpoints. Cumulative incidence functions and competing-risk regression models were used for survival analyses.</p> Results <p>Our multicenter cohort included 1796 patients, of whom, 1351 (75%) had high-grade T1, 869 (48%) had multiple tumors, and 637 (35%) had tumors arising from bladder neck or trigone. On multivariable analysis, trigone or bladder neck involvement (hazard ratio, HR: 1.24, 95% confidence interval, CI 1.02–1.49) was independently associated with worse HG-RFS. This was confirmed in a PSM analysis, which also showed worse PFS (HR: 1.45, 95% CI 1.00–2.09) and HG-RFS (HR: 1.40, 95% CI 1.08–1.82). In the SEER cohort, trigone (HR: 1.22, 95% CI 1.09–1.38) and bladder neck (HR:1.37, 95% CI 1.19–1.58) tumors were independently associated with worse CSS compared with other locations.</p> Conclusions <p>Involvement of the bladder trigone or neck is an independent prognostic factor for worse oncological outcomes in high-grade NMIBC. Further studies are needed to elucidate underlying mechanisms and determine the clinical implications for treatment decision-making.</p>

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Bladder Tumor Location Matters: Trigone and Bladder Neck Involvement Predict Worse Oncological Outcomes in High-Grade Non-Muscle-Invasive Bladder Cancer

  • 期刊论文

  • 发表日期：

    2026年3月20日

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  • Aleksander Ślusarczyk,
  • Marco Moschini,
  • Wojciech Krajewski,
  • Pietro Scilipoti,
  • Jorge Caño Velasco,
  • Laura S. Mertens,
  • Keiichiro Mori,
  • José Daniel Subiela,
  • Karolina Garbas,
  • Pedro Del Olmo Duran,
  • Francesco Claps,
  • Roberto Contieri,
  • Piotr Domański,
  • Karl Tully,
  • Elisabeth Grobet-Jeandin,
  • Alfonso Lafuente Puentedura,
  • Renee A. G. Lijnen,
  • Giorgia Fertitta,
  • Mattia Longoni,
  • Francesco Del Giudice,
  • Andrea Gallioli,
  • Ekaterina Laukhtina,
  • Gautier Marcq,
  • Andrea Mari,
  • Antonio Amodeo,
  • Luca Afferi,
  • Simone Albisinni,
  • Stephen A. Boorjian,
  • Francesco Soria,
  • Alberto Briganti,
  • Shahrokh F. Shariat,
  • Paolo Gontero,
  • Piotr Radziszewski,
  • Benjamin Pradere

摘要

Background

We aimed to evaluate the impact of bladder tumor location on oncological outcomes in high-grade non-muscle-invasive bladder cancer (NMIBC).

Patients and Methods

The testing cohort included 1796 patients with high-grade NMIBC treated with transurethral resection of bladder tumor (TURBT) and adjuvant Bacillus Calmette–Guérin (BCG). The primary endpoints were high-grade recurrence-free survival (HG-RFS) and progression-free survival (PFS). Propensity score matching (PSM) was used to adjust for clinicopathological confounders between patients with and without trigone/bladder neck involvement. External validation included 20,249 high-grade NMIBC from the Surveillance, Epidemiology, and End Results (SEER) database, with overall and cancer-specific survival (CSS) as endpoints. Cumulative incidence functions and competing-risk regression models were used for survival analyses.

Results

Our multicenter cohort included 1796 patients, of whom, 1351 (75%) had high-grade T1, 869 (48%) had multiple tumors, and 637 (35%) had tumors arising from bladder neck or trigone. On multivariable analysis, trigone or bladder neck involvement (hazard ratio, HR: 1.24, 95% confidence interval, CI 1.02–1.49) was independently associated with worse HG-RFS. This was confirmed in a PSM analysis, which also showed worse PFS (HR: 1.45, 95% CI 1.00–2.09) and HG-RFS (HR: 1.40, 95% CI 1.08–1.82). In the SEER cohort, trigone (HR: 1.22, 95% CI 1.09–1.38) and bladder neck (HR:1.37, 95% CI 1.19–1.58) tumors were independently associated with worse CSS compared with other locations.

Conclusions

Involvement of the bladder trigone or neck is an independent prognostic factor for worse oncological outcomes in high-grade NMIBC. Further studies are needed to elucidate underlying mechanisms and determine the clinical implications for treatment decision-making.