[Prognostic factors of infiltrating bladder tumors]

In France, invasive bladder cancer is the most frequent urologic malignancy after prostate carcinoma. The standard treatment of bladder cancer is radical cystectomy. New therapeutic approaches such as chemoradiation combination for a conservative procedure, neoadjuvant or adjuvant chemotherapy are still in development. In this prospect, a rigorous selection of patients is needed. This selection is based on prognostic criteria which could be divided into four groups: 1) the volume of the tumour including the tumour infiltration depth, the nodal status, the presence or not of hydronephrosis and the residual tumour burden after transuretral resection; 2) the histologic aspects including histologic grading, the presence or not of an epidermoid metaplasia, of in situ carcinoma or of thrombi; 3) the expression of circulating tumour cell biological markers; 4) the biologic characteristics of the tumour such as ploidy, presence of cytogenetic abnormalities, expression of Ki67, expression of oncogenes or tumour suppressor genes, expression of telomerase, expression of tumour antigens or growth factor receptors. This paper reviews the prognostic value of these different parameters.