Markers for recurrence of superficial bladder cancer: what is valid?

The management of superficial bladder cancer is characterized by early recognition of recurrences and the prevention of progression. Several clinical markers are used to divide patients into risk groups determining treatment and follow-up schemes. Although only a small fraction of patients will progress to invasive disease, survival of these patients is largely dictated by their bladder cancer. Whether early aggressive treatment of 'high-risk' superficial bladder cancer improves survival is not the issue of this article. Here we discuss the markers available for predicting tumour recurrence and progression. Clinical markers remain the most practical in decision-making and can identify high-risk patients. Molecular markers may be useful, but as yet insufficient evidence exists on their efficacy for daily use.