Prognosis in early carcinoma of the bladder based on chromosomal analysis

In 53 cases of non-invasive or submucosal invasive well differentiated carcinoma of the bladder observed for 4 to 101 months cytogenetic analysis by the direct technique (non-culture) has been performed repeatedly. Markers, abnormal chromosomes, have been found in 33 patients and recurrence has developed in 32 of these 33 patients, resulting in 9 deaths. All but 1 of the 20 patients without markers have been observed for up to 8 years and have remained free of recurrence. In this 1 recurrence, 8 months post-diagnosis, the mode changed from 69 to 92, evidence of dedifferentiation and development of a new tumor in a bladder prone to neoplasia. Based on our over-all cytogenetic experience with 165 patients with carcinoma of the bladder a simplified classification is presented. This classification, built on measurable characteristics of early carcinoma, including the presence or absence of marker chromosomes, allows accurate prognostication and, thus, provides the foundation for development of standard therapy.