[Surveillance and prognosis of "T1" superficial tumors of the bladder. Homogeneous series of 88 cases followed for 1 to 22 years].
OBJECTIVE
Define the prognostic factors (risk of recurrence and risk of progression) and the rules for surveillance of stage T1 papillary bladder tumours based on the clinical course of a homogeneous patient series.


METHODS
88 T1 bladder tumours recruited from 1975 to 1995 and regularly followed by the same urologist. The follow-up ranged from 1 to 22 years with a mean of 52 months and a median of 48 months.


RESULTS
26% patients relapsed (mean follow-up: 71 months) 74% developed one or more recurrences (mean follow-up: 48 months) with recurrences staged > T1 in 35% of cases. 29/88 patients died from invasive bladder cancer, 14 before 3 years, 19 before 5 years, 28 before 10 years. The risk of recurrence and progression was statistically significantly related to the macroscopic appearance of the tumour; size, number and extent of implantations; its rate of progression assessed by the frequency of recurrence. In patients with no recurrence at 12 months, the risk of recurrence decreased from 74% to 50% and the risk of progression decreased from 35% to 20%. In this cohort, neither histological grading of the initial tumour, nor the degree of invasion of the submucosal lamina propria appeared to modify the prognosis.


CONCLUSIONS
Stage T1 papillary bladder tumours, generally considered to be a superficial tumours regardless of their histological grade, have a serious prognosis and warrant close endoscopic surveillance during the year following the diagnosis. The subsequent frequency of follow-up can then be adapted to the specific mode of progression of each case, but, regardless of this mode of progression, the authors recommend long-term (life-long?) surveillance.
Lachand
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Clinique Sarrette, Compagnie Générale de Santé, 23, rue du Père Corentin, 75014 Paris. tibere@easynet.fr
Texier
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Texier
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D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology; D009367:Neoplasm Staging; D011159:Population Surveillance; D011379:Prognosis; D013997:Time Factors; D001749:Urinary Bladder Neoplasms / Q000473:pathology*
Surveillance et pronostic des tumeurs superficielles "T1" de vessie. Une série homogène de 88 cas suivis de 1 à 22 ans.