[Investigation on recurrent and evolutionary factors in superficial bladder cancer]

To evaluate clinical and pathological factors responsible for tumor recurrence, disease progression and upper urinary tract reoccurrence, we reviewed data from 244 patient with superficial bladder cancer (pTa and pT1) who were initially treated by bladder sparing operation between 1961 and 1990. The factors assessed in the present analysis included sex, age, interval between initial symptoms and first consultation, presence of hematuria, bladder irritability, tumor shape, tumor base configulation size, number, grade, stage, initial treatment, bladder instillation and medication. Accumulated recurrence rates were 13% for the first year, 20% for the second year, 23% for the third year and 28% for the fifth year. Tumor base configulation, number and grade demonstrated significant difference among each category. Multivariate analysis by the Cox's proportional hazards model confirmed that tumor number was the most important factor, followed by grade in this order. Disease progression developed in 7 patients (3%) and number and grade of tumor demonstrated significant difference. Progression was noted in 60% of multiple, G3 and pT1 tumor. Upper urinary tract recurrence developed in 5 patients (2%), however, we can find no risk factor for upper urinary tract recurrence.