[Consideration of therapeutic choice for grade 3 superficial bladder cancer]

Between January, 1977 and December, 1994, 90 patients with grade 3 (G3) superficial bladder cancer were treated at Yokohama City University Hospital, Yokohama Municipal Hospital and Kanagawa Cancer Center. These patients were clinically observed. The prognostic factors of the patients with G3 superficial bladder tumors were age and growth pattern of tumors. Patients older than 67 showed significantly poor survival compared with younger patients (p < 0.01). Patients with non-papillary sessile tumors showed significantly poor survival compared with the other groups (p < 0.05). The five-year survival rate of the patients with G3 superficial tumors who were treated by total cystectomy was 75%, whereas all the patients who were treated by bladder preservation therapy died within 4 years, the difference being significant (p < 0.05). Eleven patients with G3 superficial bladder tumors died of cancer, and most of these patients had multiple and non-papillary sessile tumors. These findings suggest that the patients with G3 superficial tumors, which are non-papillary sessile tumors, should be treated by radical cystectomy.