[T1G3 bladder tumors]

Bladder tumors T1G3 are aggressive and difficult for their staging. Out of 176 p. with tumor pT1, 16 (9%) presented pT1G3. Among the latter 4 were submitted to TUR and chemioimmunotherapy; 5 to surgical partial resection and radiotherapy; 7 to radical cystectomy. After a mean interval of 21.6 months free of relapse, 5 p. had recurrent T1 tumor below G3: 1 out of 4 after TUR; 1 out of 5 after surgical resection; 1 out of 7 after cystectomy. Clinical T1G3 8 revealed a greater pathological staging: 7 (50%) had a relapse in spite of an aggressive therapy (2 TUR; 4 surgical resection; 8 cystectomy); 5 out of the 7 relapsed revealed a greater pathological staging than T1; 2 died by metastasis. The therapeutical choice should be demolitive from the beginning. Should conservative therapy be decided, the convenience of surgical bladder resection has to be considered because, besides being effective, has some advantages over TUR: easier and unfailing staging possibility of contemporary lymphadenectomy healing of bladder by first intention.