Primary Superficial High-Grade Bladder Cancer
Risk, Recurrence and Progression
Purpose: We aimed to characterize the population with primary high-grade non muscle invasive bladder cancer followed in a Portuguese Central Hospital and simultaneously identify recurrence and progression rates and associated risk factors.
Material and Methods: The analysis included 79 patients who were diagnosed with primary high-grade non muscle invasive bladder cancer on first transurethral resection between 2006 and 2010. Several variables were statistically analyzed to evaluate their prognostic importance.
Results: With a median follow-up of 54 months, 19 patients (24.1%) recurred, four (5.1%) progressed to muscle-invasive disease and two (2.5%) underwent radical cystectomy. The most important prognostic factor of recurrence was the duration of intravesical bacillus Calmette-Guérin (BCG) treatment while the presence of carcinoma in situ was the most important prognostic factor of progression. Residual disease on second-look transurethral resection showed to reduce the recurrence-free-survival.
Conclusion: In our population, recurrence and progression rates were much lower than those described in other studies. Residual disease on second-look transurethral resection is associated with decreased recurrence-free-survival while the presence of carcinoma in situ is related with higher risk of progression. The duration of treatment with BCG seems to reduce the risk of recurrence.
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