Long term follow-up of superficial invasive bladder carcinoma with or without concomitant epithelial atypia--recurrence and progression

Scand J Urol Nephrol. 2002 Feb;36(1):52-9. doi: 10.1080/003655902317259373.

Abstract

Objective: To examine the significance of concomitant epithelial atypia on late recurrence and progression by long-term follow-up of superficial invasive bladder tumours (stage T1).

Material and methods: Seventy consecutive, unselected patients with newly diagnosed transurethral resection (TURB)-treated stage T1 bladder tumour, and at least 1 year progression-free survival. Preselected site biopsies (PSB) were obtained prospectively to evaluate the significance of concomitant urothelial atypia. Followed for up to 17.6 years.

Results: The cumulative probability of recurrence (overall) was 85%, and for new stage T1 tumour 70% after 10 years. Forty per cent of those who survived 5 years without recurrence, were readmitted with often invasive recurrence later. Positive PSB significantly (p < 0.0001) predicted new T1 tumour. Progression (T2+ or metastases) occurred in 27 cases (39%) after the first year. The cumulative probability was 60% (15 years), with a mean progression-free interval of 64 months. Positive PSB, size >3 cm and early recurrence were significant predictive factors in multivariate analysis.

Conclusion: T1-tumours are at high risk for late invasive recurrence and progression, especially if associated with urothelial atypia elsewhere in the bladder.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Carcinoma, Transitional Cell / pathology*
  • Carcinoma, Transitional Cell / therapy
  • Disease Progression
  • Disease-Free Survival
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Models, Statistical
  • Neoplasm Invasiveness
  • Neoplasm Recurrence, Local
  • Urinary Bladder Neoplasms / pathology*
  • Urinary Bladder Neoplasms / therapy
  • Urothelium / pathology