[Clinical prognostic factors in superficial cancer of the urinary bladder].
OBJECTIVE
To determine the relation of the classical prognostic factors (tumor stage, grade, size and location) to the recurrence rate, disease free interval and overall survival in patients with superficial bladder cancer.


METHODS
The study was carried out on 144 patients with superficial transitional cell carcinoma of the bladder (pTa, pT1) over a period of three years. Age, sex, history of exposure to aniline, smoking, histological type, tumor grade, size, stage, localization (single vs multiple) and type of complementary treatment were analyzed. Tumors were staged according to the TNM classification (1997 version) and cell grade was determined according to the Broders classification.


RESULTS
Mean age was 70 years +/- 12.55 (range 22-100); 124 (86%) were males and 20 (14%) were females. All tumors were superficial transitional cell carcinoma; 93% were papillary and the remaining 7% were solid tumors. There were 52 recurrences (36%); of these, only 13 (25%) showed tumor progression: 4 became infiltrating (31%), one (8%) advanced in superficial tumor stage and 8 (61%) advanced in grade. Mean follow-up was 31 months (range 3-61). Overall and disease free survival at 5 years were 88.42% and 45%, respectively. No differences were found for disease free survival according to the different prognostic factors analyzed. Tumor grade correlated with stage and size. Thus, grade III tumors are likely to be stage pT1 and greater than 3 cm. in size.


CONCLUSIONS
The histological grade is the most important prognostic factor in bladder cancer progression. However, while grade I and III tumors show a rather similar behavior, the moderately differentiated tumors comprise a heterogeneous group with a very disparate behavior. Tumor grade was found to correlate with stage and size.
Busto Catañón
L
L
Servicios de Urología, Hospital Juan Canalejo de A Coruña, España.
Sánchez Merino
J M
JM
Picallo Sánchez
J A
JA
Gelabert Mas
A
A
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002295:Carcinoma, Transitional Cell / Q000401:mortality* / Q000473:pathology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011379:Prognosis; D015996:Survival Rate; D001749:Urinary Bladder Neoplasms / Q000401:mortality* / Q000473:pathology