The Correlation of TI Bladder Tumour History with Prognosis and Follow‐up Requirements

Abstract

The histories of 332 T1 bladder cancer patients were studied to determine the natural history in this tumour population. Each was followed for at least 5 years or to earlier tumour death and the approach to treatment was conservative. Patients were potentially at serious risk of disease progression and death if they presented with tumours of G2 or G3 grade and grew new ones again after treatment or if they exhibited a continuous high level of tumor neogenesis. Fourteen developed urothelial tumours beyond the bladder, evidence of widespread urothelial instability. Tumour deaths accounted for only 12% of the series, justifying a conservative approach to treatment, and a further 25% died from unrelated causes. Those remaining tumour-free at 5 years had a low malignant potential and their natural history supported discontinuing routine cystoscopy after that time.

Papillary urothelial neoplasms of low malignant potential

“…13 In a study by England et al of 135 patients with Grade 1 urothelial carcinoma (mean follow-up, 9 years), 70% of patients had recurrence, including 7 with cancer progression, and 4 died of bladder cancer. 14 The mean interval from the time …”

Late Recurrence and Progression after a Long Tumor-Free Period in Primary Ta and T1 Bladder Cancer

“…However, the optimal length of follow-up has not been clearly established. Some recommended a discontinuance of follow-up in select cases [2, 3]. In one such study, Abel [3]recommended discontinuing urological follow-up once patients with solitary Ta tumors remained tumor-free for 1 year, those with multiple Ta tumors for 3 years, and those with T1 tumors for 5 years.…”

Multiple frequent recurrences in superficial transitional cell carcinoma of the bladder: is survival compromised by a conservative management strategy?

“…There were two upper tract tumours in 54 patients It was pointed out by England et al [1] that patients were potentially at serious risk of disease progression (3.7%) which compares with an incidence of 0.5-1.7% in all patients with superficial bladder cancer [11]. and death if they presented with tumours of G2 or G3 and grew new ones again after treatment or if they had Patients with high tumour neogenesis would be expected to be at high risk for upper tract disease due to field a continuous high level of tumour neogenesis.…”

“…The aim superficial TCC of the bladder, 70% have a recurrence after initial transurethral resection and up to one-third was to evaluate the risk of disease progression in patients with high-activity disease to evaluate whether their of these will have multiple frequent superficial recurrences, defined as greater than five recurrences at any survival was compromised by delaying cystectomy until muscle invasion had occurred. one cystoscopy [1]. This subset with high tumour neogenesis were reported to be at high risk of tumour progression and death.…”