Superficial bladder cancer: survival and prognostic factors

Two hundred and seventeen consecutive patients with superficial bladder cancer stages Ta-T1 were analyzed for survival and prognostic factors. The overall 5-year survival was 88 +/- 5.3%. Factors that impacted significantly on survival were: grade of anaplasia (GI 92 +/- 5.9% vs. GII 87 +/- 7.5% vs. GIII 68 +/- 20.7%; p = 0.01); increasing grade of anaplasia (98 +/- 1.9% vs. 55 +/- 15.6%; p less than 0.0001); progression in tumor stage (100% vs. 58 +/- 12.5%; p less than 0.0001); index of recurrences greater than 0.7 (100% vs. 71 +/- 10%; p less than 0.0001); the presence of urothelial dysplasia (98 +/- 1.7% vs. 77 +/- 9.8%; p less than 0.05); inflammatory infiltrate (90 +/- 7% vs. 83 +/- 7.3%; p less than 0.01), and residual tumor post-TUR (89 +/- 5.5% vs. 68 +/- 18.6%; p less than 0.001). Tumor stage did not impact on survival (p greater than 0.05). Using multivariate statistical analysis only the grade of anaplasia (p less than 0.0001) and increasing grade of anaplasia (p = 0.001) demonstrated significant prognostic value. Eight percent of patients died because of tumor progression. Of these patients, 87% were T1 and had concomitant urothelial dysplasia. Twenty-five percent had carcinoma in situ and the mean index of recurrence was 1.59. Seventy-five percent of patients dying because of tumor progression developed muscle-infiltrating cancer (greater than or equal to T2GIII) and 25% developed previously metastatic spread without evidence of local progression (T1GIII).(ABSTRACT TRUNCATED AT 250 WORDS)