title: Anterior urethral recurrence of superficial bladder cancer: its clinical significance.
abstract: The aim of this study was to reveal the clinical features of anterior urethral recurrence in patients with superficial bladder cancer, and to determine the appropriate treatment. Three hundred and three patients with superficial bladder cancer, who were newly diagnosed and initially treated conservatively in our hospital between 1965 and 1990, were followed for at least 5 years and their clinical outcomes were analyzed. Clinical factors, including anterior urethral recurrence, were evaluated statistically regarding tumor progression. Eight patients (2.6%) had anterior urethral recurrence following superficial bladder cancer. Twenty-four patients (7.9%) had tumor progression and 149 (49.2%) had tumor recurrence. In a multivariate analysis using a logistic model, anterior urethral recurrence was the most important factor, followed by histological grade. Four of 5 patients who were treated for anterior urethral recurrent tumors by transurethral resection showed progression and died of the cancer within one year. Two of the remaining three patients who underwent radical cysto-urethrectomy at the time of anterior urethral recurrence survived. Anterior urethral recurrence following superficial bladder cancer is a predictor for rapid subsequent malignant progression. Once there is anterior urethral recurrence, radical intensive therapy, including radical cysto-urethrectomy, should be carried out immediately.
authors.affiliation: Department of Urology, Okayama University Graduate School of Medicine and Dentistry, Okayama 700-8558, Japan. Saika@cc.okayama-u.ac.jp
authors.forename: Takashi
authors.initials: T
authors.lastname: Saika
authors.forename: Tomoyasu
authors.initials: T
authors.lastname: Tsushima
authors.forename: Yasutomo
authors.initials: Y
authors.lastname: Nasu
authors.forename: Ryoji
authors.initials: R
authors.lastname: Arata
authors.forename: Haruki
authors.initials: H
authors.lastname: Kaku
authors.forename: Naoki
authors.initials: N
authors.lastname: Akebi
authors.forename: Nobuyuki
authors.initials: N
authors.lastname: Kusaka
authors.forename: Hiromi
authors.initials: H
authors.lastname: Kumon
mesh_terms: D002295:Carcinoma, Transitional Cell / Q000401:mortality / Q000556:secondary*; D005260:Female; D006801:Humans; D008297:Male; D009364:Neoplasm Recurrence, Local / Q000401:mortality / Q000556:secondary*; D011379:Prognosis; D016016:Proportional Hazards Models; D014523:Urethral Neoplasms / Q000401:mortality / Q000556:secondary*; D001749:Urinary Bladder Neoplasms / Q000401:mortality / Q000473:pathology*