Flow cytometric DNA analysis in prediction of intravesical recurrence from human bladder-cancer

A series of 128 patients undergoing diagnostic and/or therapeutic transurethral resection for primary urothelial bladder carcinoma was prospectively studied in order to evaluate the relative importance of DNA-ploidy and S-phase fraction (SPF) by flow cytometry and of several clinicopathological features in predicting disease-free survival. Only frozen tissue was used. The mean follow-up was 22 months (range: 3-61 months). DNA-aneuploidy was present in 64% of the cases (82/128), while multiclonality was found in 29% of the DNA-aneuploid cases (24/82). In the univariate statistical analysis, high stage, DNA-aneuploidy (mono- and multiclonal patterns) and high SPF value (>11.6%) proved to be significantly related to the risk of intravesical recurrence, while a significant trend was present for histological grade. In the multivariate analysis only high SPF value (>11.6%) and DNA-aneuploidy were independently related to risk of relapse (RR of 2.39 and 2.40 respectively).