[Clinical investigation of grade-up superficial bladder cancer]

Between January 1977 and December 1993, 249 patients with grade 1 or grade 2 superficial bladder cancer were initially treated at Yokohama City University Hospital. Eighty-six patients (33%) had recurrent tumors after initial resection, and sixteen recurrent cases were so-called grade-up tumors that is, grade 3 originating from grade 1 or grade 2 tumor. The morphology of the grade-up tumors mostly showed non-papillary and invasive type. Positivity for urinary cytology of grade-up tumors was 88%. The five-year survival rate of the patients with grade-up tumors was 85% after initial resection of grade-up patients and 48% after treatment of grade-up tumors. The five-year survival rate of the patients with grade-up tumors who were treated by total cystectomy was 72%, whereas that in the patients who were treated by bladder preservation therapy showed a 13% five-year survival rate and all of the six patients died of cancer during the six-year follow-up period. These findings suggest that patients who have grade up tumors should be treated by radical treatment with radical cystectomy.