[Changes in grading at bladder tumor recurrence]

Today, transurethral resection to superficial bladder tumors is an important method, although frequent recurrence is a problem. We examined whether the degree of progressiveness could be determined at the time of recurrence and therapeutic manner decided from only the grading. Forty four cases which had recurred over twice and in which grading was changed during recurrence were examined. Recurrence occurred twice in 19 cases, and 3 times in 13 cases. Two patients had the largest number of recurrences, i.e., seven. The patients were divided in 3 groups. The 1st group consisted of 25 cases not worsening in grade from initial and recent transurethral resection-bladder tumor (TUR-Bt). The 2nd group consisted of 9 cases who had progressing grading. The 3rd group consisted of 10 cases who died of carcinoma. In the first group, grading decreased in 17 cases. Eight cases in the 3rd group were grade 4. We found that recurrent cases of bladder tumor did not always progressive, grading, being rather decreased than progressing in group 1. However, most of the grade 4 cases died of carcinoma. In conclusion, recurrent TUR-Bt in low grade bladder tumor patients may not be progressive, but grade 4 cases at recurrence require radical operation.