Prognostic parameters in superficial bladder cancer: an analysis of 315 cases

A retrospective study of 315 patients with superficial transitional cell carcinoma (stages Ta to T2) and an adequate followup of 3 years or longer is reported. Transurethral resection was done in 80 per cent of the patients and open excision or resection was done in 20 per cent for cure or control. We herein demonstrate that, in addition to grade and stage, multifocal tumor growth and whether the tumor is primary or recurrent influence the frequency of recurrences and tumor progression. The over-all recurrence rate after resection of stages Ta, T1 and T2 tumors within 3 years was 60 per cent. Recurrences after a primary tumor were noted in 45 per cent of the patients and were followed by a second recurrence in 84 per cent, with solitary tumors occurring in 46 and multifocal tumors in 73 per cent. Tumor progression was observed in 24 per cent of patients with solitary tumors, 44 per cent of those with multifocal tumors, 20 to 25 per cent of those with primary and recurrent stage Ta and primary stage T1 tumors, and 56 per cent of those with recurrent stage T1 tumors. Therefore, when therapy is planned stage, grade, multifocal tumor growth and whether the tumor is primary or recurrent should be considered. Stage Ta tumors can be treated sufficiently by transurethral resection even in the case of several recurrences. More aggressive therapy should be considered when multifocal or recurrent stage T1 or T2 tumors recur as invasive carcinomas.