"Very-low-risk" bladder tumours- a new entity?

To evaluate the homogeneity of the "low-risk" bladder cancer group in an attempt to optimize follow-up protocols.

Between June 1998 and December 2008, 211 patients (mean age of 66.7 years, S. D 12.8) underwent transurethral resection of low-risk bladder cancer. Post-operative follow-up included cystoscopy at 3 and 12 months after surgery and then annually for a total of 5 years and then annual ultrasonography indefinitely.

After a median follow-up of 10 years, 65 patients (30.7%) developed tumour recurrence and 3 (1.4%) stage-progression. Eighty-four patients (40%) had tumours ≤ 1 cm. These patients were significantly younger than patients with 1.1-3 cm tumours (64.6 years Vs. 68.3, p=0.03). Their 5-year recurrence-free survival rate was significantly higher (92% compared to 70% in patients with larger tumours, p=0.0009). Median time to recurrence was 5.7 years in patients with smaller tumours and 3.6 years in patients with larger tumours (p=0.03). Only 43.7% of the recurrences in patients with small tumours occurred within 5 years, compared to 75.5% of the larger tumours.

Patients with low-risk bladder cancer make an inhomogeneous group. They can be stratified according to tumour size. Patients with tumours smaller than 1 cm are younger, have lower risk of tumour recurrence and most of their recurrences arise beyond the recommended 5-year surveillance period. It seems that these patients can be classified separately to a "very-low-risk" group. Follow-up in these cases can be based on prolonged non-invasive evaluations. This article is protected by copyright. All rights reserved.

BJU international. 2017 Dec 23 [Epub ahead of print]

Ofer N Gofrit, Dov Pode, Galina Pizov, Mordechai Duvdevani, Ezekiel H Landau, Guy Hidas, Vladimir Yutkin

From the Departments of Urology (ONG, MD, EHL, GH, VY) and Pathology (GP) Hadassah Hebrew University Hospital, Jerusalem, Israel.

E-Newsletters

Newsletter subscription

Free Daily and Weekly newsletters offered by content of interest

The fields of GU Oncology and Urology are rapidly advancing. Sign up today for articles, videos, conference highlights and abstracts from peer-review publications by disease and condition delivered to your inbox and read on the go.

Subscribe