Should pT1 Transitional Cell Cancers of the Bladder still be Classified as Superficial?

Abstract

Of 171 patients consecutively presenting with newly diagnosed transitional cell cancer (TCC) of the bladder, 107 were "superficial"; 98 have been followed up for 2 years and 84 for 3 years. No patient with pTa TCC developed muscle infiltrating recurrences, although 15% progressed to pT1 category by 3 years. At 2 and 3 years respectively, 33 and 46% of the pT1 TCC had progressed to infiltrate muscle. The use of the term "superficial" to describe pTa and pT1 category TCC together in one grouping should be reconsidered.

Update on the management of non-muscle invasive bladder cancer

“…When treated with TUR alone, T1 tumours have a high risk of progression to muscle invasion. 16,25,26 T1G3 tumours progress in more than 50% of cases; deaths from disease occur in 25% of patients in the first 5 years and in 10% of patients between 5 to 15 years. 27 Carcinoma in situ is mostly concomitant.…”

Prognostic Value of MIB-1 Score, p53, EGFr, Mitotic Index and Papillary Status in Primary Superficial (Stage pTa/T1) Bladder Cancer: A Prospective Comparative Study

“…They all share the common characteristic of being variable between observers, and thus the prognostic estimates are also variable [3]. The pathologists are prone to place a large proportion of SBCs in the tions with stronger staining than human placenta; p53 <20% = sections with <20% of nuclei staining positively, p53≥20% = sections with ≥20% of nuclei staining positively.category ‘moderately differentiated’ [19]. This leaves the clinician with a large group of patients with a variable prognosis and uncertainty regarding the therapeutic strategy.…”

Comparative Analysis ofp53Mutations in Bladder Washings and Histologic Specimens

“…1 Between 30% and 90% of these socalled Ta and Tl tumors will recur depending on stage, grade, multifocality, and treatment modality, and between 10% and 25% will become invasive or metastasize during the course of the disease. 25 Reliable prognostic markers are urgently needed to identify patients at risk for progression to invasive disease because changes in their treatment strategies can have a major impact on the outcome of disease.…”