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Recurrence at 3 months and high-grade recurrence as prognostic factor of progression in multivariate analysis of T1G2 bladder tumors
Urology, 07/02/09

Palou J et al. - In a trial to evaluate risk factors for disease progression in the frequent subgroup of Stage T1G2 (World Health Organization 1973) bladder tumors, it was found that in primary urothelial T1G2 bladder cancer, recurrence at 3 mos was the main prognostic factor related to progression. Additional factors were the association of carcinoma in situ (CIS) with the primary tumor and presence of high-grade disease and/or CIS at first recurrence.

Methods

616 pts with Stage T1G2 were treated with transurethral resection and random bladder biopsies.
Mean follow-up was 4.2 yrs.
-Iindependent variables were multiplicity, association with carcinoma in situ (CIS), tumor size, tumor recurrence at 3 or 6 mos, tumor grade, and association with CIS at first recurrence.
Dependent variable was progression to muscle-invasive disease.

Results

Progression to muscle-invasive disease was identified in 28 of 616 pts (4.5%).
When considering recurrence at 3 mos, this factor was the principal prognostic factor, with a relative risk of 4.0, followed by presence of high-grade disease or CIS at first recurrence and CIS associated with the primary tumor.
When considering recurrence at 6 mos, more prognostic factors were involved for progression, including as multiple tumors, CIS associated with primary tumor, recurrence at 6 mos, and presence of high-grade disease or CIS at the first recurrence.

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