Intravesical therapy in superficial bladder cancer.
OBJECTIVE
To identify the appropriate characteristics of superficial bladder cancer that allow the physician to predict tumor behavior.


METHODS
We analyzed 1,745 patients with primary superficial bladder cancer with regard to disease and patient characteristics.


RESULTS
With the characteristics we found, the population can be described and prognostic factors can be found. Moreover, with the use of these factors, it appears to be possible to predict tumor behavior on a group level. Prediction on an individual level, however, remains far from ideal.


CONCLUSIONS
Three treatment options can be chosen: follow-up after initial transurethral resection, additional instillations with intravesical chemotherapy, or instillations with bacillus Calmette-Guerin (BCG). In case instillations are indicated, most (but not all) superficial bladder cancer trials show superiority of BCG over intravesical chemotherapy, although at the cost of more side effects. However, with intravesical BCG, it seems possible to influence the natural history of superficial bladder cancer, which means that we can delay progression and improve survival.
Witjes
J A
JA
Department of Urology, University Hospital, Nijmegen, The Netherlands.
Mulders
P F
PF
Debruyne
F M
FM
D000283:Administration, Intravesical; D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D001500:BCG Vaccine / Q000627:therapeutic use*; D002295:Carcinoma, Transitional Cell / Q000453:epidemiology / Q000628:therapy*; D003131:Combined Modality Therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology*; D009426:Netherlands / Q000453:epidemiology; D011379:Prognosis; D012307:Risk Factors; D013997:Time Factors; D001749:Urinary Bladder Neoplasms / Q000453:epidemiology / Q000628:therapy*
D000970:Antineoplastic Agents; D001500:BCG Vaccine