PROSCA/BLADDR 2023 | Risk stratification in NMIBC: are we really doing it the right way?

Felix Guerrero-Ramos, MD, PhD, Hospital Universitario 12 de Octubre in Madrid, Spain, discusses the challenges in stratifying non-muscle invasive bladder cancer patients. Various staging systems exist, with the 2021 EU guidelines being the most recent. However, it has limitations as it excluded patients who received Bacillus Calmette-Guérin (BCG), leading to overestimated progression rates. External validations revealed low discrimination ability for recurrence and better, but still suboptimal, discrimination for progression. Molecular classifications, while promising, have imperfections, with up to 20% of the worst prognosis group progressing. Implementation challenges include cost and feasibility in smaller centers. Dr Guerrero-Ramos envisions future improvements through machine learning, integrating clinical and molecular factors for enhanced classification. This interview took place at the Global Congress on Prostate and Bladder Cancer (PROSCA/BLADDR) 2023 in Malaga, Spain.

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