title: Management of superficial bladder cancer in Victoria: 1990 and 1995.
abstract: BACKGROUND
  A retrospective survey of medical practitioners was undertaken to describe the tumour characteristics, management and outcomes of all superficial bladder cancers newly diagnosed in 1990 and in 1995 in Victoria.
  
  
  METHODS
  Cases were identified from the population cancer registry. The survey was conducted in 1999 and the cohort followed up until 2000 to obtain at least 5 years of follow-up data on all patients, in particular to identify recurrence of tumour as assessed at surveillance cystoscopy and progression to muscle invasive cancer.
  
  
  RESULTS
  Tumour recurrence was observed in 390/610 patients (63.9%), of whom 56.9% had their recurrence noted at the first check cystoscopy. Ultimately 43 (6.3%) of patients progressed to invasive disease, with this subgroup demonstrating 5-year overall survival of 35% (95% confidence interval (CI) 21-49%). Ultimately survival was proportional to the extent of tumour invasion, being greater in low-risk patients (76%, 95% CI 72-80%, mucosal disease only) than in high-risk patients (46%, 95% CI 36-56%, lamina propria invasion noted at diagnosis).
  
  
  CONCLUSIONS
  In low-risk subgroups of patients with superficial transitional cell carcinoma, the frequency of surveillance cystoscopy may be able to be reduced to levels in accordance with established European guidelines without a likely impact on patient survival. Where progression to muscle invasive disease does ensue, more aggressive management may be warranted in order to try to improve survival.
authors.affiliation: Department of Urology, Monash University, Monash Medical Centre, Clayton, Victoria, Australia. frydenberg@optusnet.com.au
authors.forename: Mark
authors.initials: M
authors.lastname: Frydenberg
authors.forename: Jeremy L
authors.initials: JL
authors.lastname: Millar
authors.forename: Guy
authors.initials: G
authors.lastname: Toner
authors.forename: Damien
authors.initials: D
authors.lastname: Bolton
authors.forename: Rodney
authors.initials: R
authors.lastname: Syme
authors.forename: Vicky J
authors.initials: VJ
authors.lastname: Thursfield
authors.forename: Graham G
authors.initials: GG
authors.lastname: Giles
mesh_terms: D000368:Aged; D002295:Carcinoma, Transitional Cell / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy*; D003558:Cystoscopy; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008297:Male; D009361:Neoplasm Invasiveness; D009364:Neoplasm Recurrence, Local; D017410:Practice Guidelines as Topic; D011379:Prognosis; D012042:Registries; D012189:Retrospective Studies; D016019:Survival Analysis; D016896:Treatment Outcome; D001749:Urinary Bladder Neoplasms / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy*; D014739:Victoria / Q000453:epidemiology