'Very‐low‐risk' bladder tumours – a new entity?. (17th January 2018)

• Record Type: Journal Article
• Authors: Gofrit, Ofer N.; Pode, Dov; Pizov, Galina; Duvdevani, Mordechai; Landau, Ezekiel H.; Hidas, Guy; Yutkin, Vladimir
• Is Part Of: BJU international. Volume 121:Number 4(2018)
• Page Start: 627
• Page End: 631
• Publication Date: 2018-01-17
• Subjects: low‐grade bladder cancer -- very‐low‐grade bladder cancer -- prognosis -- follow‐up -- #blcsm -- #BladderCancer; Genitourinary organs -- Diseases -- Periodicals; Genitourinary organs -- Surgery -- Periodicals; Urology -- Periodicals; 616.6
• DOI: 10.1111/bju.14108
• Languages: English
• ISSNs: 1464-4096

Abstract

Abstract : Objective: To evaluate the homogeneity of the 'low‐risk' bladder cancer group in an attempt to optimise follow‐up protocols. Patients and Methods: Between June 1998 and December 2008, 211 patients (mean [sd ] age of 66.7 [12.8] years) underwent transurethral resection of low‐risk bladder cancer. Postoperative follow‐up included cystoscopy at 3 and 12 months after surgery, then annually for a total of 5 years, and then annual ultrasonography indefinitely. Results: After a median follow‐up of 10 years, 65 patients (30.7%) developed tumour recurrence and three (1.4%) stage progressions. In all, 84 patients (40%) had tumours of ≤1 cm; these patients were significantly younger than patients with 1.1–3 cm tumours (64.6 vs 68.3 years, P = 0.03). Their 5‐year recurrence‐free survival rate was significantly higher (92% vs 70% in patients with larger tumours, P < 0.001). The 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% in patients with larger tumours. Conclusions: Patients with low‐risk bladder cancer make an inhomogeneous group. They can be stratified according to tumour size. Patients with tumours of ≤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.