2024
Long‐term outcomes of bladder‐sparing therapy vs radical cystectomy in BCG‐unresponsive non‐muscle‐invasive bladder cancer
Taylor J, Kamat A, O'Donnell M, Annapureddy D, Howard J, Tan W, McElree I, Davaro F, Yim K, Harrington S, Dyer E, Black A, Kanabur P, Roumiguié M, Lerner S, Black P, Raman J, Preston M, Steinberg G, Huang W, Li R, Packiam V, Woldu S, Lotan Y. Long‐term outcomes of bladder‐sparing therapy vs radical cystectomy in BCG‐unresponsive non‐muscle‐invasive bladder cancer. BJU International 2024 PMID: 39183466, DOI: 10.1111/bju.16509.Peer-Reviewed Original ResearchNon-muscle-invasive bladder cancerBladder-sparing therapyUpfront RCRadical cystectomyCohort of patientsBladder cancerBCG-unresponsive NMIBCRetrospective cohort of patientsProgression to MIBCUpfront radical cystectomyCancer-specific survivalInstitutional review board approvalMetastasis-free survivalFood and Drug Administration criteriaRate of recurrenceReview board approvalLong-term outcomesStatistically significant differenceNodal diseaseRe-resectionSystemic immunotherapyIntravesical chemotherapyOncological outcomesOverall survivalOncological riskBladder-sparing Therapy for Bacillus Calmette-Guérin–unresponsive Non–muscle-invasive Bladder Cancer: International Bladder Cancer Group Recommendations for Optimal Sequencing and Patient Selection
Li R, Hensley P, Gupta S, Al-Ahmadie H, Babjuk M, Black P, Brausi M, Bree K, Fernández M, Guo C, Horowitz A, Lamm D, Lerner S, Lotan Y, Mariappan P, McConkey D, Mertens L, Mir C, Ross J, O'Donnell M, Palou J, Pohar K, Steinberg G, Soloway M, Spiess P, Svatek R, Tan W, Taoka R, Buckley R, Kamat A. Bladder-sparing Therapy for Bacillus Calmette-Guérin–unresponsive Non–muscle-invasive Bladder Cancer: International Bladder Cancer Group Recommendations for Optimal Sequencing and Patient Selection. European Urology 2024 PMID: 39183090, DOI: 10.1016/j.eururo.2024.08.001.Peer-Reviewed Original ResearchNon-muscle-invasive bladder cancerInternational Bladder Cancer GroupBladder-sparing treatmentCarcinoma in situNadofaragene firadenovecRadical cystectomyBladder cancerOptimal selection of patientsAbsence of randomized trialsBladder-sparing therapySingle-agent chemotherapyBladder cancer groupSelection of patientsDevelopment of agentsPatient selectionSystemic toxicityCancer groupUnapproved agentsClinical trial participationPatient characteristicsRandomized trialsMitomycin CTumor attributesConsensus recommendationsCancer expertsInfluence of lamina propria invasion extension on T1 high‐grade non‐muscle‐invasive bladder cancer in patients undergoing BCG or radical cystectomy
Contieri R, Tan W, Grajales V, Hensley P, Martini A, Bree K, Myers A, Nogueras‐Gonzalez G, Navai N, Dinney C, Guo C, Kamat A. Influence of lamina propria invasion extension on T1 high‐grade non‐muscle‐invasive bladder cancer in patients undergoing BCG or radical cystectomy. BJU International 2024, 133: 733-741. PMID: 38374533, DOI: 10.1111/bju.16293.Peer-Reviewed Original ResearchConceptsNon-muscle-invasive bladder cancerImmediate radical cystectomyCancer-specific survivalMetastasis-free survivalProgression-free survivalT1 substagingOverall survivalRadical cystectomyPathology reportsBladder cancerHigh-grade non-muscle-invasive bladder cancerPatients treated with bacillus Calmette-GuerinAssociated with poor progression-free survivalInstitutional review board-approved retrospective studyPatients treated with BCGPoor progression-free survivalLamina propriaAssociated with upstagingBCG-treated patientsCalculate overall survivalTreated with BCGKaplan-Meier methodHigh-grade patientsMultivariate Cox modelInvasive characteristicsAssociation of Age with Non–muscle-invasive Bladder Cancer: Unearthing a Biological Basis for Epidemiological Disparities?
Lobo N, Duan Z, Sood A, Tan W, Grajales V, Contieri R, Lindskrog S, Dyrskjøt L, Zhao H, Giordano S, Williams S, Bree K, Kamat A. Association of Age with Non–muscle-invasive Bladder Cancer: Unearthing a Biological Basis for Epidemiological Disparities? European Urology Oncology 2024, 7: 1069-1079. PMID: 38302322, DOI: 10.1016/j.euo.2024.01.011.Peer-Reviewed Original ResearchNon-muscle-invasive bladder cancerBladder cancer-specific mortalitySEER-Medicare dataSEER-MedicareAge disparitiesTumor biologyAdequate cancer careEnd Results (SEER)-MedicareSEER-Medicare cohortBladder cancerUROMOL cohortOncological outcomesMultivariate general linear modelCancer-specific mortalitySEER-Medicare patientsMultinomial logistic regressionAssociation of ageAssociated with inferior oncological outcomesCompeting-risks regressionCancer careAdvanced ageT1 non-muscle-invasive bladder cancerHigh risk of recurrenceClinical stage TaMultivariable competing-risks regression
2023
Reply to Wen-Wei Sung’s Letter to the Editor re: Wei Shen Tan, Ian M. McElree, Facundo Davaro, et al. Sequential Intravesical Gemcitabine and Docetaxel Is an Alternative to Bacillus Calmette-Guérin for the Treatment of Intermediate-risk Non–muscle-invasive Bladder Cancer. Eur Urol Oncol. 2023;6:531–534
Tan W, O'Donnell M, Li R, Kamat A, Packiam V. Reply to Wen-Wei Sung’s Letter to the Editor re: Wei Shen Tan, Ian M. McElree, Facundo Davaro, et al. Sequential Intravesical Gemcitabine and Docetaxel Is an Alternative to Bacillus Calmette-Guérin for the Treatment of Intermediate-risk Non–muscle-invasive Bladder Cancer. Eur Urol Oncol. 2023;6:531–534. European Urology Oncology 2023, 7: 164-165. PMID: 39492318, DOI: 10.1016/j.euo.2023.10.009.Peer-Reviewed Original ResearchIntermediate-risk non-muscle-invasive bladder cancerNon-muscle-invasive bladder cancerBacillus Calmette-GuerinIntravesical gemcitabineOncological Outcomes for Patients with European Association of Urology Very High-risk Non–muscle-Invasive Bladder Cancer Treated with Bacillus Calmette-Guérin or Early Radical Cystectomy
Contieri R, Hensley P, Tan W, Grajales V, Bree K, Nogueras-Gonzalez G, Lee B, Navai N, Dinney C, Kamat A. Oncological Outcomes for Patients with European Association of Urology Very High-risk Non–muscle-Invasive Bladder Cancer Treated with Bacillus Calmette-Guérin or Early Radical Cystectomy. European Urology Oncology 2023, 6: 590-596. PMID: 37558542, DOI: 10.1016/j.euo.2023.07.012.Peer-Reviewed Original ResearchConceptsNon-muscle-invasive bladder cancerCancer-specific mortalityBacillus Calmette-GuerinHigh-grade recurrenceHigh-risk non-muscle-invasive bladder cancerOverall survivalBladder cancerEuropean Urological AssociationOncological outcomesNo significant differenceEarly RCPatients treated with bacillus Calmette-GuerinTreated with bacillus Calmette-GuerinNon-muscle invasive bladder cancerIntravesical BCGContemporary cohort of patientsCancer-specific mortality ratesProgression rateBacillus Calmette-Guerin groupEarly radical cystectomyMedian follow-upInvasive bladder cancerSignificant differenceCohort of patientsEarly surgical removalImpact of age >70 years on oncological outcomes in patients with non‐muscle‐invasive bladder cancer treated with Bacillus Calmette–Guérin
Contieri R, Grajales V, Tan W, Martini A, Sood A, Hensley P, Bree K, Lobo N, Nogueras‐Gonzalez G, Guo C, Navai N, Dinney C, Kamat A. Impact of age >70 years on oncological outcomes in patients with non‐muscle‐invasive bladder cancer treated with Bacillus Calmette–Guérin. BJU International 2023, 133: 63-70. PMID: 37442564, PMCID: PMC10787034, DOI: 10.1111/bju.16127.Peer-Reviewed Original ResearchConceptsNon-muscle-invasive bladder cancerBacillus Calmette-GuerinCancer-specific mortalityCompeting-risk regression analysisCohort of patientsOncological outcomesFood and Drug AdministrationHG recurrenceAssociated with adverse oncologic outcomesHigh-gradeImpact of ageInstitutional review board-approved retrospective studyBacillus Calmette-Guerin instillationsIntravesical BCGCumulative incidence of progressionAdverse oncologic outcomesIncidence of progressionAssociation of advanced ageUnited States Food and Drug AdministrationStates Food and Drug AdministrationCumulative incidence methodPredictors of progressionStudy's primary outcomeBCG instillationRegression analysisSequential Intravesical Gemcitabine and Docetaxel is an Alternative to Bacillus Calmette-Guérin for the Treatment of Intermediate-risk Non–muscle-invasive Bladder Cancer
Tan W, McElree I, Davaro F, Steinberg R, Bree K, Navai N, Dinney C, O'Donnell M, Li R, Kamat A, Packiam V. Sequential Intravesical Gemcitabine and Docetaxel is an Alternative to Bacillus Calmette-Guérin for the Treatment of Intermediate-risk Non–muscle-invasive Bladder Cancer. European Urology Oncology 2023, 6: 531-534. PMID: 37468392, DOI: 10.1016/j.euo.2023.06.011.Peer-Reviewed Original ResearchConceptsNon-muscle-invasive bladder cancerBacillus Calmette-GuerinIntermediate-risk non-muscle-invasive bladder cancerInternational Bladder Cancer GroupBladder cancerIntermediate-riskMulti-institutional retrospective reviewBlue light cystoscopyCombination of docetaxelEvaluate oncological outcomesHigh-grade diseaseMedian follow-upCancer-specific mortalityTreatment groupsCancer control outcomesBladder cancer groupSequential gemcitabineChemotherapy combinationsOncological outcomesIntravesical gemcitabinePostoperative chemotherapyAdjuvant treatmentRetrospective reviewRecurrence rateCancer groupClinical trial design for non-muscle-invasive bladder cancer
Tan W, Hall E, Kamat A, Kelly J. Clinical trial design for non-muscle-invasive bladder cancer. Nature Reviews Urology 2023, 20: 575-576. PMID: 37328547, DOI: 10.1038/s41585-023-00789-0.Peer-Reviewed Original ResearchConceptsNon-muscle-invasive bladder cancerClinical trial designTrial designBladder cancerEvaluate new therapiesNew therapiesPatient characterizationCancerBacillus Calmette–Guérin (BCG) unresponsive non‐muscle‐invasive bladder cancer: are the subgroups equal?
Tan W, Grajales V, Bree K, Li R, Nogueras‐Gonzalez G, Navai N, Dinney C, Kamat A. Bacillus Calmette–Guérin (BCG) unresponsive non‐muscle‐invasive bladder cancer: are the subgroups equal? BJU International 2023, 132: 384-386. PMID: 37246493, DOI: 10.1111/bju.16087.Peer-Reviewed Original ResearchBladder-sparing Treatment in Patients with Bacillus Calmette-Guerin–unresponsive Non–muscle-invasive Bladder Cancer: An Analysis of Long-term Survival Outcomes
Tan W, Grajales V, Contieri R, Hensley P, Bree K, Msaouel P, Guo C, Nogueras-Gonzalez G, Navai N, Dinney C, Kamat A. Bladder-sparing Treatment in Patients with Bacillus Calmette-Guerin–unresponsive Non–muscle-invasive Bladder Cancer: An Analysis of Long-term Survival Outcomes. European Urology Open Science 2023, 53: 16-22. PMID: 37441349, PMCID: PMC10334230, DOI: 10.1016/j.euros.2023.04.013.Peer-Reviewed Original ResearchNon-muscle-invasive bladder cancerBladder-sparing treatmentLong-term survival outcomesCancer-specific survivalBCG-unresponsive NMIBC patientsEarly radical cystectomyRadical cystectomySurvival outcomesOverall survivalBladder cancerDelayed RCNMIBC patientsEarly RCAnalysis of long-term survival outcomesHigh-grade recurrenceProgression-free rateRecurrence-free rateMedian follow-upShort-term outcomesLong-term outcomesCurrent smoker statusCT1 diseaseLymphovascular invasionVariant histologyPrimary endpointA0605 Association of age with non-muscle-invasive bladder cancer: A biological basis for epidemiological disparities?
Lobo N, Sood A, Duan Z, Tan W, Grajales V, Lindskrog S, Dyrskjøt L, Zhao H, Giordano S, Williams S, Kamat A. A0605 Association of age with non-muscle-invasive bladder cancer: A biological basis for epidemiological disparities? European Urology 2023, 83: s863. DOI: 10.1016/s0302-2838(23)00651-6.Peer-Reviewed Original ResearchEpidemiological disparitiesNon-muscle-invasive bladder cancerBladder cancerDisparitiesAssociationBiological basis
2022
Reply to Suman Sahoo, Abhishek Pandy, Swarnendu Mandal, Manoj Kumar Das, and Prasant Nayak’s Letter to the Editor re: Wei Shen Tan, Aaron Pendergast, Charlotte Ackerman, et al. Adjuvant Intravesical Chemohyperthermia Versus Passive Chemotherapy in Patients with Intermediate-risk Non–muscle-invasive Bladder Cancer (HIVEC-II): A Phase 2, Open-label, Randomised Controlled Trial. Eur Urol. In press. https://doi.org/10.1016/j.eururo.2022.08.003
Tan W, Mustard C, Kelly J, team H. Reply to Suman Sahoo, Abhishek Pandy, Swarnendu Mandal, Manoj Kumar Das, and Prasant Nayak’s Letter to the Editor re: Wei Shen Tan, Aaron Pendergast, Charlotte Ackerman, et al. Adjuvant Intravesical Chemohyperthermia Versus Passive Chemotherapy in Patients with Intermediate-risk Non–muscle-invasive Bladder Cancer (HIVEC-II): A Phase 2, Open-label, Randomised Controlled Trial. Eur Urol. In press. https://doi.org/10.1016/j.eururo.2022.08.003. European Urology 2022, 83: e48-e49. PMID: 36456403, DOI: 10.1016/j.eururo.2022.11.006.Peer-Reviewed Original ResearchConceptsIntermediate-risk non-muscle-invasive bladder cancerNon-muscle-invasive bladder cancerRandomised controlled trialsOpen-labelBladder cancerControlled trialsReply to Fabio Campodonico, Francesca Mattioli, and Carlo Introini’s Letter to the Editor re: Wei Shen Tan, Aaron Pendergast, Charlotte Ackerman, et al. Intravesical Chemohyperthermia Versus Passive Chemotherapy in Patients with Intermediate-risk Non–muscle-invasive Bladder Cancer (HIVEC-II): A Phase 2, Open-label, Randomised Controlled Trial. Eur Urol. In press. https://doi.org/10.1016/j.eururo.2022.08.003
Tan W, Kelly J, team H. Reply to Fabio Campodonico, Francesca Mattioli, and Carlo Introini’s Letter to the Editor re: Wei Shen Tan, Aaron Pendergast, Charlotte Ackerman, et al. Intravesical Chemohyperthermia Versus Passive Chemotherapy in Patients with Intermediate-risk Non–muscle-invasive Bladder Cancer (HIVEC-II): A Phase 2, Open-label, Randomised Controlled Trial. Eur Urol. In press. https://doi.org/10.1016/j.eururo.2022.08.003. European Urology 2022, 83: e29-e30. PMID: 36272948, DOI: 10.1016/j.eururo.2022.10.009.Peer-Reviewed Original ResearchConceptsIntermediate-risk non-muscle-invasive bladder cancerNon-muscle-invasive bladder cancerRandomised controlled trialsOpen-labelBladder cancerControlled trialsRobotic Intracorporeal Neobladder: UCLH Experience
Weyne E, Tan W, Kelly J, Sridhar A. Robotic Intracorporeal Neobladder: UCLH Experience. 2022, 681-686. DOI: 10.1007/978-3-031-00363-9_60.Peer-Reviewed Original ResearchRobot-assisted radical cystectomyUniversity College London HospitalRadical cystectomyBladder cancerHigh-risk non-muscle-invasive bladder cancerTreatment of muscle-invasive bladder cancerNon-muscle-invasive bladder cancerMuscle-invasive bladder cancerRobotic radical cystectomyOrthotopic continent diversionPatient selectionContinent diversionCystectomyPostoperative careOperative techniqueNeobladderAdjuvant Intravesical Chemohyperthermia Versus Passive Chemotherapy in Patients with Intermediate-risk Non–muscle-invasive Bladder Cancer (HIVEC-II): A Phase 2, Open-label, Randomised Controlled Trial
Tan W, Prendergast A, Ackerman C, Yogeswaran Y, Cresswell J, Mariappan P, Phull J, Hunter-Campbell P, Lazarowicz H, Mishra V, Rane A, Davies M, Warburton H, Cooke P, Mostafid H, Wilby D, Mills R, Issa R, Kelly J. Adjuvant Intravesical Chemohyperthermia Versus Passive Chemotherapy in Patients with Intermediate-risk Non–muscle-invasive Bladder Cancer (HIVEC-II): A Phase 2, Open-label, Randomised Controlled Trial. European Urology 2022, 83: 497-504. PMID: 35999119, DOI: 10.1016/j.eururo.2022.08.003.Peer-Reviewed Original ResearchConceptsIntermediate-risk non-muscle-invasive bladder cancerNon-muscle-invasive bladder cancerDisease-free survivalAdverse eventsBladder cancerMitomycin CChemotherapy instillationOpen-labelControl armAdjuvant intravesical chemotherapyProgression-free survivalPhase 2 randomised controlled trialIntention-to-treat analysisLow gradePer-protocol analysisChemohyperthermia groupIntravesical chemotherapyUrinary cytologyHeated chemotherapyOverall survivalWeekly instillationsTumor resectionPrimary endpointRandomised controlled trialsChemohyperthermiaIntermediate-risk Non–muscle-invasive Bladder Cancer: Updated Consensus Definition and Management Recommendations from the International Bladder Cancer Group
Tan W, Steinberg G, Witjes J, Li R, Shariat S, Roupret M, Babjuk M, Bivalacqua T, Psutka S, Williams S, Cookson M, Palou J, Kamat A. Intermediate-risk Non–muscle-invasive Bladder Cancer: Updated Consensus Definition and Management Recommendations from the International Bladder Cancer Group. European Urology Oncology 2022, 5: 505-516. PMID: 35718695, DOI: 10.1016/j.euo.2022.05.005.Peer-Reviewed Original ResearchConceptsNon-muscle-invasive bladder cancerInternational Bladder Cancer GroupBladder cancer groupManagement of patientsIntermediate-riskIntravesical treatmentCancer groupRisk factorsClinical trialsIntravesical chemotherapyMultifocal tumorsEarly recurrenceTumor sizeBladder cancerFrequent recurrenceHeterogeneous diseaseGrading systemCarcinoma in situStage of tumorPostoperative intravesical chemotherapyRandomized clinical trialsMaintenance BCGComparison of outcomesRecurrent diseaseClinical practice guidance
2021
Is delay to radical cystectomy following BCG failure oncologically safe?
Tan W, Kelly J. Is delay to radical cystectomy following BCG failure oncologically safe? Nature Reviews Urology 2021, 18: 323-324. PMID: 33772157, DOI: 10.1038/s41585-021-00457-1.Peer-Reviewed Original Research
2020
Exploring patients’ experience and perception of being diagnosed with bladder cancer: a mixed‐methods approach
Tan W, Teo C, Chan D, Ang K, Heinrich M, Feber A, Sarpong R, Williams N, Brew‐Graves C, Ng C, Kelly J, Khetrapal P, Sridhar A, Baker H, Ocampo F, Whotton N, Dent K, Pearson S, Hatton J, Newton M, Heeney E, Green K, Evans S, Rogers M, Dann A, Cook J, Cornwell M, Mills R, Knight H, Maher S, Rane A, Thomas S, Reyner S, Vallejera G, Adeniran P, Masood S, Ridgway S, Coulding M, Savill H, Mccormick J, Clark M, Collins G, Jewers K, Keith S, Bowen G, Hargreaves J, Riley K, Srirangam S, Mistry R, Chadwick J, Cocks S, Hull R, Loftus A, Dawson L, Roberts H, Main C, Jain S, Waymont C, Rogers J, Grant A, Carter V, Heap H, Lomas C, Cooke P, Baird Y, Moore S, Greenslade S, Margalef J, Chadbourn I, Harris M, Hicks J, Clitheroe P, Connolly S, Hodgkinson S, Haydock H, Sinclair A, Storr E, Cogley L, Natale S, Lovegrove W, Smith S, Smith K, Hewitt D, Sriram R, Atkinson K, Royle L, Madine J, MacLean K, Walsh J, Guerdette A, Hill M, Payne D, Power A, Cannon J, Devereaux L, Thompson A, Scarratt L, Hodgkiss T, Johnstone D, Johnson J, Allsop J, Rothwell J, Connolly K, Cherian J, Wardle H, Wilson D, Bayles A, Pelluri S, Pati J, Gherman A, Scott C, Madaan S, Taylor J, Edmunds E, Moore J, Rees A, Williams S, Caddy S, Dukes S, Goffe A, Buckhorn K, Nichols L, Acher P, Baillie K, Middleton K, Proctor C, Cresswell J, Chilvers A, Cain M, Vaux A, Watson D, Bradfield S, Gregory H, Mostafid H, Kehoe L, Drakeley S, Davies J, Williamson L, Krishnan R, Lunt N, Hill P, Burns H, Townley B, Wilkinson L, Wassall H, Sinclair A, Hunt J, Holbrook B, Stancombe L, Morrison J, Vankoutrik L, Misra S, Fossey G, Richards A, Mcdonald K, Henderson A, Fennelly R, Tribbeck M, Ames K, Borwell J, Kotze M, Beesley K, Rennie K, Porter T, Gipson A, Piper L, Bailey L, Chrisopoulou A, Slevin K, McCartin F, Warburton H, Hathaway‐Lees S, Whetton K, Delves G, Day A, Bankole T, Broadhead S, Malde S, Oblak M, Ellis D, Bishara S, Barias‐Lara T, Donkov I, Thatcher H, Morris H, Culmsee C, Menzies A, Bartlett C, Cutting C, O'Brien N, Jannapureddy R, Kelkar A, Fitzgerald J, Longhurst S, Worth C, Peracha A, Mzazi S, Poile C, Griffiths L, Cook A, Barber N, Brar N, Alty A, Zelhof B, Blades R. Exploring patients’ experience and perception of being diagnosed with bladder cancer: a mixed‐methods approach. BJU International 2020, 125: 669-678. PMID: 31975539, PMCID: PMC7318301, DOI: 10.1111/bju.15008.Peer-Reviewed Original ResearchConceptsNon-muscle-invasive bladder cancer diagnosisPatient experienceNon-muscle-invasive bladder cancerTransurethral resection of bladder tumorCancer diagnosisBrief IPQMixed-methods approachBrief Illness Perception QuestionnaireCause of bladder cancerRisk of bladder cancerMental health of patientsIllness Perception QuestionnairePersonal controlBladder cancerHealth of patientsSemi-structured interviewsPerception of disease controlLow personal controlMental healthProspective multicentre observational studyPsychological supportUrine biomarker studiesPerception QuestionnaireDiagnosis of non-muscle-invasive bladder cancerPoor perception
2019
Effects of Bladder Cancer on UK Healthcare Costs and Patient Health-Related Quality of Life: Evidence From the BOXIT Trial
Cox E, Saramago P, Kelly J, Porta N, Hall E, Tan W, Sculpher M, Soares M. Effects of Bladder Cancer on UK Healthcare Costs and Patient Health-Related Quality of Life: Evidence From the BOXIT Trial. Clinical Genitourinary Cancer 2019, 18: e418-e442. PMID: 32144049, PMCID: PMC7427321, DOI: 10.1016/j.clgc.2019.12.004.Peer-Reviewed Original ResearchConceptsHealth-related quality of lifeNon-muscle-invasive bladder cancerMuscle-invasive bladder cancerProgression to muscle-invasive bladder cancerQuality of lifePatients' health-related quality of lifePatients' health-related qualityBladder cancerHealth-related qualityEQ-5D-3LGeneralized estimating equationsUK unit costsRandomized controlled trialsHRQoL decrementNon-muscle-invasive bladder cancer patientsHRQoLHealthcare costsHRQOL effectsLimited evidenceControlled trialsEstimating equationsTMN classificationClinical eventsAverage costRecurrence