Late Invasive Recurrence Despite Long-Term Surveillance for Superficial Bladder Cancer

Thompson, Robert; Campbell, Edward W.; Kramer, Howard C.; Jacobs, Stephen C.; Naslund, Michael J.

doi:10.1016/s0022-5347(17)36282-1

Cited by 52 publications

(20 citation statements)

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“…Because 70% of bladder carcinomas are superficial at diagnosis (Thompson et al, 1993), surgical cure ought to be attainable in at least these patients. The actual clinical course in BC is nevertheless remarkably heterogeneous, with as many as 60% of patients with superficial disease having recurrence(s) after transurethral resection of the primary tumour(s) (Fitzpatrick et al, 1986).…”

Section: Discussionmentioning

confidence: 99%

“…Although 70% of newly diagnosed bladder TCCs are superficial, i.e. the tumour is confined to the lamina propria, the disease represents a major therapeutic challenge and a continuous threat to the patients since the tumours recur after transurethral resection of the primary in more than 70% of the cases Thompson et al, 1993). In addition, progression to more advanced stages and/or grades occurs in 16Ð25% of the cases (Prout et al, 1992).…”

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confidence: 99%

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Cytogenetic monoclonality in multifocal uroepithelial carcinomas: evidence of intraluminal tumour seeding

et al. 1999

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Summary Twenty-one multifocal urinary tract transitional cell carcinomas, mostly bladder tumours, from a total of six patients were processed for cytogenetic analysis after short-term culturing of the tumour cells. Karyotypically related, often identical, cytogenetically complex clones were found in all informative tumours from each case, including the recurrent tumours. Rearrangement of chromosome 9, leading to loss of material from the short and/or the long arm, was seen in all cases, indicating that this is an early, pathogenetically important event in transitional cell carcinogenesis. The presence of related clones with great karyotypic similarity in anatomically distinct tumours from the same bladder indicates that multifocal uroepithelial tumours have a monoclonal origin and arise via intraluminal seeding of viable cancer cells shed from the original tumour. Later lesions may develop also from cells shed from the so called second primary tumours. The relatively complex karyotypes seen in all lesions from most cases argue that the seeding of tumour cells is a late event that succeeds the acquisition by them of multiple secondary genetic abnormalities.

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Section: Discussionmentioning

confidence: 99%

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confidence: 99%

Cytogenetic monoclonality in multifocal uroepithelial carcinomas: evidence of intraluminal tumour seeding

et al. 1999

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“…Treatment failure is common, with 60% of superficial tumors recurring after standard transurethral resection (Heney et al, 1993;Thompson et al, 1993), and in 16% to 25% of these relapses, the recurring lesions are of higher grade (Prout et al, 1992). Prior identification of those carcinomas that are prone to recur and/or progress would allow more aggressive early surgical intervention, possibly combined with intravesical adjuvant chemo-or immunotherapy, which eventually might substantially reduce morbidity as well as mortality from BC.…”

Section: Introductionmentioning

confidence: 99%

Karyotypic characterization of urinary bladder transitional cell carcinomas

Fadl-Elmula

Gorunova

Mandahl

et al. 2000

Genes Chromosom. Cancer

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“…Heney et al [7] reported that only about 10% of superficial TCC develop progression to a deeper pT category and/or worse grade or 30% of pT1 disease progress to muscle infiltration within a median follow-up of 39 months. Available literature to date evaluating long-term outcome in superficial bladder cancer has relied on actuarial methods but has not analyzed tumor status at first check cystoscopy [2,14,15] . However, the study of Parmar et al [6] has shown that two factors, the number of tumors at presentation and the result of the 3-month cystoscopy study, are of considerable prognostic importance in predicting the interval to a subsequent recurrence.…”

Section: Discussionmentioning

confidence: 99%

TA T1 Low and Intermediate Transitional Cell Carcinoma of the Bladder: Recurrence Rates and the Timing of Check Cystoscopies within the First Year

Güney

Canogullari

et al. 2008

Urol Int

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Introduction: The intensity of cystoscopic follow-up in the first year for patients with superficial bladder cancer has not been clearly defined. The cystoscopic follow-up of superficial bladder cancer accounts for a considerable workload for the urologist and is also an invasive procedure with high costs. We retrospectively reviewed our experience to determine any possible criteria which can lead to reduce the frequency of check cystoscopy. Material and Methods: A retrospective study was done on 427 patients with primary stage Ta and T1 bladder cancers treated between 1998 and 2005. The pattern of recurrence in the first year was assessed and recurrence rates calculated. Results: The recurrence rate was 22% at 3 months. The recurrence rates at 6 and 9 months were 8 and 13.6% respectively. The recurrence rate at 12 months was 9.4%. For tumors with no recurrence at 3 months, the recurrence rates at 6, 9 and 12 months were 6.6, 13.4 and 8.9% respectively. With respect to stages, there was a statistically significant difference in recurrence rate stages pTa and pT1 in the first and in the third control (p = 0.001, p = 0.003) respectively. According to the recurrence rate within the first year, the difference between G1 and G2 tumors was not statistically significant regardless of the stage (p > 0.05). Conclusions: Patients with initial stage Ta or T1 grade 1 and 2 bladder cancers and negative first cystoscopy have a significantly lower recurrence rate than those with recurrence at first cystoscopy. There is a reason to change follow-up routines but in our opinion only in patients with initial low-grade carcinoma. If the third-month cystoscopy is clear, it is appropriate to perform the first check cystoscopy 1 year after initial resection.

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Late Invasive Recurrence Despite Long-Term Surveillance for Superficial Bladder Cancer

Cited by 52 publications

References 14 publications

Cytogenetic monoclonality in multifocal uroepithelial carcinomas: evidence of intraluminal tumour seeding

Cytogenetic monoclonality in multifocal uroepithelial carcinomas: evidence of intraluminal tumour seeding

Karyotypic characterization of urinary bladder transitional cell carcinomas

TA T1 Low and Intermediate Transitional Cell Carcinoma of the Bladder: Recurrence Rates and the Timing of Check Cystoscopies within the First Year

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