title: Analysis of factors predicting intravesical recurrence of superficial transitional cell carcinoma of the bladder without concomitant carcinoma in situ.
abstract: BACKGROUND
  The objective of this study was to investigate risk factors for intravesical recurrence in patients with superficial bladder cancer without concomitant carcinoma in situ (CIS).
  
  
  METHODS
  In this series, we analyzed data from patients with newly diagnosed superficial Ta or T1 transitional cell carcinoma (TCC) of the bladder without concomitant CIS who underwent complete transurethral resection (TUR) without any adjuvant intravesical instillation therapies. Multivariate analysis was used to determine significant risk factors affecting intravesical recurrence after TUR. Differences in clinicopathological features between primary and recurrent tumors were also characterized.
  
  
  RESULTS
  Among 341 patients undergoing TUR of Ta or T1 bladder cancer, 187 diagnosed as having concomitant CIS and/or treated with adjuvant intravesical therapy were excluded, and the remaining 154 were evaluated. Intravesical recurrence was detected in 64 of the 154 patients, showing a 5-year recurrence-free survival rate of 58.3%. Among several factors examined, only tumor size was significantly associated with intravesical recurrence. Multivariate analysis identified tumor size as an independent predictor for intravesical recurrence irrespective of other parameters including age, gender, multiplicity, growth pattern, grade and stage. Recurrent tumors were significantly smaller and of a lower grade and lower stage than primary tumors, despite the absence of differences in growth pattern and the multiplicity between them.
  
  
  CONCLUSIONS
  These findings suggest that primary tumor size could be used as a potential risk factor for predicting intravesical recurrence following TUR of superficial TCC of the bladder without concomitant CIS, and that the pathological characteristics of recurrent tumors are more favorable than those of primary tumors.
authors.affiliation: Department of Urology, Hyogo Medical Center for Adults, Akashi, Japan.
authors.forename: Iori
authors.initials: I
authors.lastname: Sakai
authors.forename: Hideaki
authors.initials: H
authors.lastname: Miyake
authors.forename: Ken-Ichi
authors.initials: K
authors.lastname: Harada
authors.forename: Isao
authors.initials: I
authors.lastname: Hara
authors.forename: Taka-Aki
authors.initials: TA
authors.lastname: Inoue
authors.forename: Masato
authors.initials: M
authors.lastname: Fujisawa
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002278:Carcinoma in Situ / Q000473:pathology / Q000601:surgery*; D002295:Carcinoma, Transitional Cell / Q000473:pathology / Q000601:surgery*; D002648:Child; D002675:Child, Preschool; D018450:Disease Progression; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009364:Neoplasm Recurrence, Local; D011379:Prognosis; D012307:Risk Factors; D001749:Urinary Bladder Neoplasms / Q000473:pathology / Q000601:surgery*