Abstract：Objective To establish and validate a quantitative prediction model for recurrence risk of non-muscle invasive bladder cancer (NMIBC) patients after transurethral resection of bladder tumor (TURBT).Methods From December 2014 to December 2019,a total of 310 patients with NMIBC receiving TURBT were chosed for the retrospective study,they were randomly divided into model group (170 cases) and verification group (140 cases). The model group was divided into relapse group (90 cases) and non-recurrence group (80 cases) for subgroup analysis. The European Organization for Research and Treatment of Cancer (EORTC) risk stratification was used to divide the model group into low risk group(21 cases), medium risk group(119 cases) and high risk group(30 cases). The difference in RFS was compared by Kaplan-Meier survival curve. Then, clinical data, tumor characteristics and biochemical markers were compared between the two groups. Multivariate logistic regression analysis was used to screen the main risk factors, a new quantitative scoring system was established according to weight assignment, and receiver operating characteristic(ROC) curve was used to analyze the diagnostic efficiency of the scoring system in the verification group. Finally, according to the optimal critical value of the scoring system, the risk stratification of model groups was carried out, and the difference of RFS survival curves was compared again.Results There was no significant difference in RFS between model groups based on EORTC risk stratification (P>0.05). Multivariate logistic regression analysis showed that family history, chemotherapy drug bladder perfusion, maximum diameter, low differentiation, BLCA-4, BTA, NMP22 and CEA levels were the main risk factors for tumor recurrence (all P<0.05). ROC analysis showed that the accuracy of the scoring system in predicting recurrence in the verification group was 0.865, and the critical value was 3.8 scores(total score 6～7 scores). >4 was classified as high risk and<4 was classified as low risk. RFS of high risk patients in the model group was significantly lower than that of low risk patients (χ2=6.235，P=0.003). The RFS of high-risk patients in the verification group was significantly lower than that of lowrisk patients (χ2=5.867，P=0.007).Conclusions EORTC is not accurate for patients with NMIBC after TURBT in China. Family history, bladder perfusion, maximum diameter, low differentiation, BLCA-4, BTA, NMP22 and CEA levels may be the main risk factors to tumor recurrence. The quantitative scoring system has a good accuracy for the prediction of tumor recurrence, and has a good application value for RFS evaluation.
