Bladder Cancer Recurrence and Progression Calculator (EORTC)

This EORTC tool evaluates key tumor factors to predict bladder cancer recurrence and progression risks at 1 and 5 years, helping guide treatment decisions. For informational use only—consult healthcare professionals.

Bladder Cancer Recurrence and Progression Calculator (EORTC)

This EORTC tool predicts bladder cancer recurrence and progression risks to guide treatment decisions.

Quiz progress: Question 1 out of 5

Question 1

In the past month, how frequently have you felt overwhelmed by unexpected events?

Never

Rarely

Occasionally

Often

Very often

Your EORTC Bladder Cancer Risk Assessment

You successfully completed the assessment. Review your recurrence and progression risk below.

Recurrence Risk: Progression Risk:

Your EORTC Bladder Cancer Risk Assessment Results

Recurrence Risk

Risk Group	Score	1-year Risk	5-year Risk
Low	0	15%	31%
Intermediate-Low	1-4	24%	46%
Intermediate-High	5-9	38%	62%
High	10-17	61%	78%

Progression Risk

Risk Group	Score	1-year Risk	5-year Risk
Low	0	0.2%	0.8%
Intermediate-Low	2-6	1%	6%
Intermediate-High	7-13	5%	17%
High	14-23	17%	45%

Your current risk level will be highlighted based on your calculated scores.

What should I do now?

Understanding the EORTC Bladder Cancer Risk Assessment

The EORTC Bladder Cancer Recurrence and Progression Calculator is a validated tool used to evaluate the risk of recurrence and progression in patients with non-muscle invasive bladder cancer (NMIBC). Developed by the European Organization for Research and Treatment of Cancer (EORTC), it provides probability estimates that help guide treatment decisions and follow-up scheduling.

NMIBC accounts for approximately 75% of bladder cancer diagnoses. While these patients generally have good survival rates, there is a significant potential for tumor recurrence within the bladder and progression to more advanced stages. This calculator helps quantify these risks based on clinical and pathological factors.

The Six Key Risk Factors

Number of Tumors: Multiple tumors indicate a higher risk. The calculator distinguishes between single tumors, 2-7 tumors, and 8 or more tumors. Each category carries different point values for recurrence and progression risk calculation.

Tumor Size: Larger tumors (≥3 cm in diameter) are associated with higher risks of both recurrence and progression compared to smaller tumors (<3 cm).

Prior Recurrence Rate: A history of recurrence significantly impacts future risk. The calculator classifies patients as having primary disease (no previous recurrence), ≤1 recurrence per year, or >1 recurrence per year.

T Category: This refers to the tumor stage. Ta tumors are confined to the bladder lining (urothelium), while T1 tumors have invaded the connective tissue layer (lamina propria) but not the muscle. T1 tumors carry a substantially higher progression risk.

Carcinoma in Situ (CIS): The presence of CIS, a high-grade flat tumor confined to the lining, significantly increases progression risk. CIS is always high grade, requires immediate treatment, and worsens the prognosis.

Tumor Grade: This reflects how abnormal the cancer cells appear. G1 tumors are well-differentiated (less aggressive), G2 are moderately differentiated, and G3 are poorly differentiated (more aggressive). Higher grades carry greater risks, particularly for progression.

How Risk Scores Are Calculated

For each of the six factors, points are assigned separately for recurrence and progression risk. The total recurrence score can range from 0 to 17, while the progression score ranges from 0 to 23. These scores are then translated into percentage risks at both 1 year and 5 years.

The recurrence risk at 1 year ranges from 15% (score of 0) to 61% (score of 10-17), and at 5 years from 31% to 78%. The progression risk at 1 year ranges from 0.2% (score of 0) to 17% (score of 14-23), and at 5 years from 0.8% to 45%.

Clinical Application and Limitations

The EORTC calculator helps urologists and patients make informed decisions about treatment intensity and follow-up frequency. For example, patients with higher risk scores may benefit from more aggressive treatment approaches, including intravesical therapy (medication delivered directly into the bladder) and more frequent surveillance.

It's important to note that while this calculator provides valuable risk stratification, it has some limitations. Validation studies, such as the one by Xylinas et al., showed the model has modest discrimination with C-statistics between 0.597-0.662. This means the calculator should be used as a guideline alongside clinical judgment rather than as the sole determinant of treatment decisions.

For optimal bladder cancer management, the calculator results should be discussed with your urologist, who will consider these risk estimates along with other factors specific to your situation, including your overall health, treatment preferences, and quality of life considerations.