Computerisation of urothelial carcinoma records: 16 years' experience with the TNM system

Details of 554 patients with urothelial carcinomas have been recorded on computer forms between 1973 and 1988 inclusive. Essential information from initial assessment and follow-up examinations was printed out on specially designed urothelial update sheets, copies of which were given to patients and urologists as well as being filed in the hospital notes. The survival status of all patients was established as accurately as possible in the last 2 years of the study. Multivariate analysis of 462 bladder cancer patients with adequate follow-up indicated that T category was the most important discriminating variable, followed by histological grade. After replacing T category by microscopic depth of invasion and bimanual examination, the latter was found to be the most important single variable. The omission of the findings on bimanual examination from the 1987 revision of the TNM classification therefore appears to be wrong.