title: Tumour location adjacent to the ureteric orifice in primary Ta/T1 bladder cancer is predictive of recurrence.
abstract: OBJECTIVE
  The aim of this study was to evaluate tumour growth located around the ureteric orifice (LUO) at primary diagnosis of Ta/T1 urinary bladder cancer in relation to effects on recurrence and progression.
  
  
  METHODS
  Clinical and pathological characteristics of patients diagnosed with primary Ta/T1 urinary bladder cancer from 1992 to 2007 were recorded prospectively. Location of the primary tumour and growth around the ureteric orifice (within 1 cm) were recorded and correlated with recurrence and progression during further follow-up. Hazard ratios (HRs) were estimated using Cox regression with 95% confidence intervals (CIs) in both univariate and multivariate analysis.
  
  
  RESULTS
  The study included 768 evaluable patients with a median follow-up of 60 months. Recurrence was observed in 478 patients (62%) and progression in 71 (9%). Growth of a primary tumour adjacent to the ureteric orifice was associated with recurrence (HR = 1.28, 95% CI = 1.07-1.54) but not progression (HR = 1.04, 95% CI = 0.65-1.67). The most common location of the first recurrence was the posterior bladder wall (29%). Other locations in the bladder did not predict recurrence or progression. Additional factors affecting recurrence were tumour size greater than 15 mm, T1 tumour category, multiplicity, malignant or missing/not representative bladder wash cytology and surgery performed by residents.
  
  
  CONCLUSIONS
  A primary tumour located around the ureteric orifice was predictive of recurrence, which could be taken into account in future follow-up schedules.
authors.affiliation: a 1 Division of Urology, Department of Clinical and Experimental Medicine, Linköping University , Linköping, Sweden.
authors.forename: Georg
authors.initials: G
authors.lastname: Jancke
authors.affiliation: b 2 Oncology Centre, University Hospital , Linköping, Sweden.
authors.forename: Johan
authors.initials: J
authors.lastname: Rosell
authors.affiliation: a 1 Division of Urology, Department of Clinical and Experimental Medicine, Linköping University , Linköping, Sweden.
authors.forename: Staffan
authors.initials: S
authors.lastname: Jahnson
mesh_terms: D000276:Adjuvants, Immunologic / Q000627:therapeutic use; D000283:Administration, Intravesical; D000368:Aged; D000369:Aged, 80 and over; D001500:BCG Vaccine / Q000627:therapeutic use; D002295:Carcinoma, Transitional Cell / Q000473:pathology* / Q000628:therapy; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology*; D009366:Neoplasm Seeding; D016016:Proportional Hazards Models; D011446:Prospective Studies; D014513:Ureter / Q000473:pathology*; D001743:Urinary Bladder / Q000473:pathology* / Q000601:surgery; D001749:Urinary Bladder Neoplasms / Q000473:pathology* / Q000628:therapy; D013520:Urologic Surgical Procedures
chemical_list: D000276:Adjuvants, Immunologic; D001500:BCG Vaccine
keywords: Bladder cancer; recurrence; tumour location; ureteric orifice