Development and Internal Validation of the BRICS Score: A Preoperative Clinical and Hematological Model for Predicting High-Grade and Muscle-Invasive Bladder Cancer

Background/Objectives: We developed and internally validated the Bladder Risk Index using Clinical and Systemic biomarkers (BRICS), a preoperative prediction model designed to estimate the likelihood of high-grade (HG) disease and muscle-invasive bladder cancer (MIBC) in patients undergoing their first transurethral resection of bladder tumor (TURBT).

Methods

This retrospective single-center study included 161 patients with newly diagnosed urothelial bladder cancer. The BRICS-HG model included tumor size, neutrophil-to-lymphocyte ratio (NLR), and creatinine-to-hemoglobin ratio (CHR), while the BRICS-MIBC model was based on tumor size and NLR. Model performance was assessed in terms of discrimination, calibration, and Brier score, together with exploratory decision curve analysis. Internal validation was performed using 2000 bootstrap resamples.