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Vol. 80, No. 2, 2008
Issue release date: March 2008
Urol Int 2008;80:124–128
(DOI:10.1159/000112600)

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

Guney S. · Guney N. · Canogullari Z. · Ergenekon E.
aSisli Etfal Research and Training Hospital, Urology Clinic, and bInstitute of Oncology, Istanbul University, Istanbul, Turkey

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Abstract

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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References

  1. Malmström PU, Busch C, Norlen BJ: Recurrences, progression and survival in bladder cancer. A retrospective analysis of 232 patients with greater than or equal to 5-year follow-up. Scand J Urol Nephrol 1987;21:185–195.
  2. Leblanc B, Duclos AJ, Bernard F, Cote J, Valiquette L, Paquin JM, Mauffette F, Faucher R, Perreault JP: Long-term fallow up of initial Ta grade 1 transitional cell carcinoma of the bladder. J Urol 1999;62:1946–1950.

    External Resources

  3. Cutler SJ, Heney NM, Friedell GH: Longitudinal study of patients with bladder cancer: factors associated with disease recurrence and progression; in Bonney WW, Prout GR (eds): Bladder Cancer. Baltimore, Williams & Wilkins, 1982, pp 35–46.
  4. Dalesio O, Schulman CC, Sylvester R, De Pauw M, Robinson M, Dennis L, Smith P, Viggiano G: Prognostic factors in superficial bladder tumors. A study of the European Organization for Research on Treatment of Cancer: Genitourinary Tract Cancer Cooperative Group. J Urol 1983;129:730–733.
  5. Smith G, Elton RA, Chisholm GP, Newsam JE, Hargreave TB: Superficial bladder cancer: intravesical chemotherapy and tumour progression to muscle invasion or metastases. Br J Urol 1986;58:659–663.
  6. Parmar MK, Freedman LS, Hargreave TB, Tolley DA: Prognostic factors for recurrence and follow-up policies in the treatment of superficial bladder cancer: report from the British Medical Research Council Subgroup on Superficial Bladder Cancer (Urological Cancer Working Party). J Urol 1989;142:284–288.
  7. Heney NM, Ahmed S, Flaganan MJ, Frable W, Corder MP, Hafermann MD, Hawkins IR, for National Bladder Cancer Colloborative Group A: Superficial bladder cancer: progression and recurrence. J Urol 1983;130:1083–1086.
  8. Lamm DL: Long-term results of intravesical therapy for superficial bladder cancer. Urol Clin North Am 1992;19:573–580.
  9. Epstein JI, Amin MB, Reuter VR, Mastofi FK: The World Health Organization/International Society of Urologic Pathology Consensus Classification of Urothelial (Transitional Cell) Neoplasm of the Urinary Bladder: Bladder Consensus Conference Committee. Am J Surg Pathol 1998;1435–1448.
  10. Sobin LH, Wittekind C: TNM Classification of Malignant Tumors, ed 5: Urogenital Tumors. New York, Wiley, 1997, pp 187–190.
  11. Konety BR, Getzenberg RH: Urine-based markers of urological malignancy. J Urol 2001;165:600–611.
  12. Morgan JD, Bowsher W, Griffiths DFR: Rationalization of follow-up in patients with non-invasive bladder tumors. A preliminary report. Br J Urol 1991;67:158–161.
  13. Kolozsy Z: Histopathological self-control in transurethral resection of bladder tumors. Br J Urol 1991;67:162–164.
  14. Thompson RA, Campbell EW, Kramer HC, Jacobs SC, Naslund MJ: Late invasive recurrence despite long-term surveillance for superficial bladder cancer. J Urol 1993;149:1010–1011.
  15. Morris SB, Gordon EM, Shearer RJ, Woodhouse CR: Superficial bladder cancer: for how long should a tumour-free patient have check cystoscopies? BJU 1995;75:193–196.
  16. Fitzpatrick JM, West AB, Butler MR, Lane V, O’Flynn JD: Superficial bladder tumors (stage pTa, grades 1 and 2): the importance of recurrence pattern following initial resection. J Urol 1986;135:920–922.
  17. Abel PD: Follow-up of patient with superficial transitional cell carcinoma of the bladder: the case for a change in policy. Br J Urol 1993;72:135–142.
  18. Hall RR, Parmar MK, Richards AB, Smith PH: Proposal changes in cystoscopic follow-up of patients with bladder cancer and adjuvant intravesical chemotherapy. BMJ 1994;308:257–260.
  19. Morris SB, Shearer RJ, Gordon EM, Woodhouse CR: Superficial bladder cancer: timing of check cystoscopies in the first year. Br J Urol 1993;72:446–448.
  20. Oge O, Erdem E, Atsu N, Şahin A, Ozen H: Proposal for changes in cystoscopic follow-up of patients with low-grade pTa bladder tumor. Eur Urol 2000;37:271–274.
  21. Bryan RT, Wallace DM: Superficial bladder cancer: time to uncouple pT1 tumours from pTa tumours. BJU Int 2002;90:846.
  22. Prout GR, Barton BA, Griffin PP, Friedell GH: Treated history of noninvasive grade 1 transitional cell carcinoma. The National Bladder Cancer Group. J Urol 1992;148:1413–1419.
  23. Kiemeney LA, Witjes JA, Heijbroek RP, Verbeek AL, Debruyne FM: Predictability of recurrent and progressive disease in individual patients with primary superficial bladder cancer. J Urol 1993;150:60–64.
  24. Allard P, Bernard P, Fradet Y, Tetu B: The early clinical course of primary Ta and T1 bladder cancer: a proposed prognostic index. Br J Urol 1998;81:692–698.
  25. Reading J, Hall RR, Parmar MK: The application of a prognostic factor analysis for TaT1 bladder cancer in routine urological practice. Br J Urol 1995;75:604–607.


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