Prognostic Factors in Superficial Bladder Tumor / 대한비뇨기과학회지

ABSTRACT

A retrospective analysis of prognostic factors based on 249 patients with primary superficial bladder tumors (78 Ta, 166 T1, 5 Tis) during a 10-year period beginning 1978 was performed. Easily available routine clinical and pathological data such as stage (Ta, T1 or Tis) , grade( I, II or III), size (smaller or larger than 3cm), number (less or more than 3) and recurrence pattern (earlyrecurrence within 6 months of followup or late) were tested. Univariate analysis was performed with generalized Wilcoxon test and univariate analysis of significance of the data was done with Cox's proportional hazard model. The most significant prognostic factors with respect to the recurrence were multiplicity in time and space and grade, while the stage and size were less significant. The most influential factor with tumor progression was tumor grade. Based on these 5 variables 3 different subgroups of patients can be identified. In good risk group including grade I , single, small and late recurrent tumor, 2 year recurrence rate ( recurrences per 100 patients' months) was 44% (3.82) and 96 patients (38%) were comprised in. In poor risk group including all grade III or Tis tumor, the recurrence rate was 96% (15.12% ) and 29 patients (12% ) were comprised in Tumor progression was noticed in 140% of this group. The third is intermediate risk group (G I-II with various number, size and recurrent pattern) which comprised 124 patients(50%) and was less distinctive and less homogeneous than other group. In this group the recurrence rate was 71 % (7.25 ) and progression rate was 16%, The patients in this group subsequently can be recategorized with further followup. Followup plan and definite treatment decision has to be made according to the classification. Intensive followup and aggressive treatment in poor risk group and less stringent followup in good risk group appeared to be imperative. This kind of approach would minimize the possibility of treatment which is too much or too little for the patients.