Chonnam Med J.  2003 Jun;39(2):98-106.

Univariate and Multivariate Analysis of the Factors in Recurrence and Progression of Superficial Bladder Cancer

• Kang TW
• Lee JG
• Kim KS
• Hwang EC
• Oh BR
• Ryu SB
• Park YI

Abstract

To evaluate the prognostic factors of recurrence and progression in patients with primary superficial Ta and T1 transitional cell carcinoma of the bladder, we retrospectively reviewed the medical records of 161 patients with superficial bladder tumor. The tumor recurrence and progression was assessed in relation to the tumor size, shape, grade (except grade III), stage, multiplicity, intravesical instillation after TUR. Mean age of the patients was 58.0 years, with the mean follow-up duration 58.8 months. Statistical analyses were performed using the Kaplan-Meier method and Scheffe test, and univariate and multivariate analysis, which was done with the Cox proportional hazards model with stepwise forward selection. Multiple tumors was the only significant prognostic factor of recurrence in the Cox analysis (p=0.007). Intravesical bacillus Calmette- Guerin (BCG) instillation was the only significant factor of progression in the univariate Cox analysis (p=0.014), whereas intravesical epirubicin instillation was also significant in the multivariate analysis (p=0.047). Kaplan-Meier univariate analysis showed that progression factors were tumor grade, stage and intravesical, instillation and that intravesical BCG instillation increased the progression-free survival rates (p<0.05). Multiple tumors was the only risk factor of recurrence. Intravesical BCG instillation was the only prognostic factor of progression. Also, intravesical BCG instillation therapy effectively lowered the progression rate in superficial bladder cancer more effectively than other adjuvant intravesical chemotherapy, but it did not affect the recurrence.

Keyword

Superficial bladder cancer; Risk factors; Intravesical instillation; Recurrence; Progression

MeSH Terms

Administration, Intravesical
Bacillus
Carcinoma, Transitional Cell
Disease-Free Survival
Drug Therapy
Epirubicin
Follow-Up Studies
Humans
Medical Records
Multivariate Analysis*
Mycobacterium bovis
Proportional Hazards Models
Recurrence*
Retrospective Studies
Risk Factors
Urinary Bladder Neoplasms*
Urinary Bladder*
Epirubicin