title: Recurrence pattern for superficial bladder cancer.
abstract: OBJECTIVE
  Patients with superficial bladder tumors sometimes have long recurrence-free intervals. We evaluated whether patients with long recurrence-free periods had subsequent recurrences. We also clarified how these patients should be followed.
  
  
  METHODS
  We enrolled 244 patients with superficial bladder cancer (62 pTa and 182 pT1) treated by transurethral resection of bladder tumor (TURBT) and adjuvant chemotherapy with pirarubicin. Median follow up was 75.5 months. Patients were stratified by the length of their recurrence-free interval.
  
  
  RESULTS
  Recurrences occurred in 124 patients (50.8%). Of 185 patients who did not have a recurrence for the first 3 years, subsequent recurrences occurred in 65 patients; in more than half the first recurrence developed after 5 years or more. Ta tumors had a low recurrence rate (14.5%) with the first recurrence often developing after a long recurrence-free period. Of 40 patients who remained recurrence-free for 3 years or more after at least one recurrence occurred, 16 patients (40%) had subsequent recurrences. Furthermore, most of these patients who remained free of recurrence for more than 5 years eventually had a recurrence. The overall progression rate was 15.6%, and this did not relate to the length of the recurrence-free interval.
  
  
  CONCLUSIONS
  When patients did not have a recurrence for the first 3 years, tumors subsequently often recurred, even in pTa tumors. In patients with at least once recurrence, subsequent recurrences appear to occur irrespective of the length of the recurrence-free period. Thus, we recommend that all patients with superficial bladder tumors be followed for as long as possible.
authors.affiliation: Department of Urology, Sanjukai Urological Hospital, Sapporo, Hokkaido, Japan. akagashi@sanjukai.or.jp
authors.forename: Keigo
authors.initials: K
authors.lastname: Akagashi
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Tanda
authors.forename: Shuji
authors.initials: S
authors.lastname: Kato
authors.forename: Shigeki
authors.initials: S
authors.lastname: Ohnishi
authors.forename: Hisao
authors.initials: H
authors.lastname: Nakajima
authors.forename: Akihito
authors.initials: A
authors.lastname: Nanbu
authors.forename: Toshikazu
authors.initials: T
authors.lastname: Nitta
authors.forename: Mikio
authors.initials: M
authors.lastname: Koroku
authors.forename: Yoshikazu
authors.initials: Y
authors.lastname: Sato
authors.forename: Tatsuo
authors.initials: T
authors.lastname: Hanzawa
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017024:Chemotherapy, Adjuvant / Q000379:methods; D018572:Disease-Free Survival; D004317:Doxorubicin / Q000008:administration & dosage / Q000031:analogs & derivatives; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000401:mortality* / Q000628:therapy; D015996:Survival Rate; D001749:Urinary Bladder Neoplasms / Q000401:mortality* / Q000628:therapy
chemical_list: D007166:Immunosuppressive Agents; D004317:Doxorubicin; C027260:pirarubicin