Follow-up of patients with noninvasive and superficially invasive bladder cancer.
Low-grade carcinomas (pTaG1) comprise 50% of all stage pTa-pT1 carcinomas and have an almost benign course of disease. Follow-up policies may be changed so that patients with a single tumor at diagnosis and a negative cystoscopy at 3 months should be examined 9 months later. Check cystoscopies may be performed with flexible instruments and a considerable number of the recurrences could be managed with fulguration under urethral anesthesia only. Because low-grade carcinomas are so common, the seriousness of the other tumors in stages pTa-pT1 is not fully appreciated. Patients with high-grade carcinoma (pTaG2-G3, pT1G2-G3) have at least a 70% risk for recurrence and a 20% risk for stage progression. The course of disease is more unpredictable than for patients with low-grade carcinoma, and there are at present no firm data that support a change in follow-up routines. Routine follow-up urographies are not necessary.
Holmäng
S
S
Department of Urology, Sahlgrenska University Hospital, Göteborg, Sweden.
D002295:Carcinoma, Transitional Cell / Q000175:diagnosis* / Q000453:epidemiology; D003558:Cystoscopy; D018450:Disease Progression; D005500:Follow-Up Studies; D006801:Humans; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology; D009367:Neoplasm Staging; D011379:Prognosis; D013997:Time Factors; D001743:Urinary Bladder / Q000473:pathology; D001749:Urinary Bladder Neoplasms / Q000175:diagnosis* / Q000453:epidemiology; D014567:Urography