The National Comprehensive Cancer Network has adopted a new risk model from the International Bladder Cancer Group to better classify patients with intermediate-risk non–muscle-invasive bladder cancer. Instead of treating all patients the same way, this approach helps doctors decide who needs more aggressive treatment and who can receive less intensive care.
The model looks at five key factors: having multiple tumors, tumor size of 3 cm or larger, cancer returning within one year, frequent recurrences, and failure of prior bladder-based treatments. Based on how many of these factors a patient has, they are placed into three groups: low risk (no factors), intermediate risk (one to two factors), and high risk (three or more factors).
A 2024 study of 677 patients confirmed the model works well. After three years, recurrence rates were 29.5% in the low-risk group, 36.9% in the intermediate group, and 67.5% in the high-risk group. High-risk patients were more than three times as likely to have their cancer return compared to low-risk patients.
This new guideline helps doctors tailor treatment more precisely, ensuring high-risk patients get the care they need while avoiding unnecessary side effects and costs for lower-risk patients.