The treated natural history of high risk superficial bladder cancer: 15-year outcome Journal Article
| Authors: | Cookson, M. S.; Herr, H. W.; Zhang, Z. F.; Soloway, S.; Sogani, P. C.; Fair, W. R. |
| Article Title: | The treated natural history of high risk superficial bladder cancer: 15-year outcome |
| Abstract: | Purpose: The long term outcome of patients with high risk superficial bladder cancer is unknown. We report the results of 15 years of followup of high risk patients treated initially with aggressive local therapy, including transurethral resection alone or combined with in travesical bacillus Calmette-Guerin. Materials and Methods: Between 1978 and 1981, 86 high risk patients enrolled in a randomized study of transurethral resection alone or with intravesical bacillus Calmette-Guerin for superficial bladder cancer. Of these patients 81% had diffuse carcinoma in situ and 44% had stage T1 tumors before entry into the study. Patients were followed until death (61%) or until the present time (median followup 184 months). Results: Disease stage progressed in 46 patients (53%) and 31 (36%) eventually underwent cystectomy for progression (28) or refractory carcinoma in situ (3), while 18 (21%) had upper tract tumors at a median of 7.3 years. The 10 and 15-year disease specific survival rates were 70 and 63%, respectively. At 15 years 34% of patients overall were dead of bladder cancer, 27% were dead of other causes and 37% were alive, including 27% with an intact functioning bladder. Conclusions: Despite aggressive local therapy patients with high risk superficial bladder cancer are at lifelong risk for development of stage progression and upper tract tumors. A third of patients are at risk for death from bladder cancer, justifying careful and vigilant long term follow up. These results support the use of initial aggressive local therapy in patients with high risk superficial bladder cancer. |
| Keywords: | cancer survival; controlled study; treatment outcome; middle aged; major clinical study; clinical trial; dose response; follow-up studies; neoplasm staging; prospective studies; bcg vaccine; controlled clinical trial; neoplasm recurrence, local; randomized controlled trial; risk factors; urinary bladder neoplasms; high risk patient; time factors; disease progression; carcinoma in situ; cystectomy; bladder neoplasms; transurethral resection; bladder carcinoma; intravesical drug administration; humans; prognosis; human; male; female; priority journal; article |
| Journal Title: | Journal of Urology |
| Volume: | 158 |
| Issue: | 1 |
| ISSN: | 0022-5347 |
| Publisher: | Elsevier Science, Inc. |
| Date Published: | 1997-07-01 |
| Start Page: | 62 |
| End Page: | 67 |
| Language: | English |
| DOI: | 10.1097/00005392-199707000-00017 |
| PUBMED: | 9186324 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | Source: Scopus |
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