Prognostic Parameters in Superficial Bladder Cancer: An Analysis of 315 Cases

Abstract

A retrospective study of 315 patients with superficial transitional cell carcinoma (stages Ta to T2) and an adequate followup of 3 yr or longer is reported. Transurethral resection was done in 80% of the patients; open excision or resection was done in 20% for cure or control. In addition to grade and stage, multifocal tumor growth and whether the tumor is primary or recurrent evidently influence the frequency of recurrences and tumor progression. The over-all recurrence rate after resection of stages Ta, T1 and T2 tumors within 3 yr was 60%. Recurrences after a primary tumor were noted in 45% of the patients and were followed by a 2nd recurrence in 84%, with solitary tumors occurring in 46 and multifocal tumors in 73%. Tumor progression was observed in 24% of patients with solitary tumors, 44% of those with multifocal tumors, 20-25% of those with primary and recurrent stage Ta and primary stage T1 tumors, and 56% of those with recurrent stage T1 tumors. Therefore, when therapy is planned, stage, grade, multifocal tumor growth and whether the tumor is primary or recurrent should be considered. Stage Ta tumors can be treated sufficiently by transurethral resection even in the case of several recurrences. More aggressive therapy should be considered when multifocal or recurrent stage T1 or T2 tumors recur as invasive carcinomas.