Pathologic Prognostic Indicators in Recurrence and Progression of Superficial Bladder Tumor

Kwak, Tae Il; Yoon, Duck Ki; Kim, Kwang Il; Won, Nam Hee

Abstract

PURPOSE: The identification of factors present at the time of initial evaluation may be important to predict the prognosis in patients with superficial bladder carcinoma. Attempts were made to identify predictive factors of recurrence and progression.
MATERIALS AND METHODS
This study included twenty seven patients with superficial bladder tumor(pTa-pTl) who had no recurrence within 5 years. A comparative non-randomized study was performed of a control group of twenty six patients with same superficial bladder tumor who had recurrence within 1 year after transurethral resection of bladder tumor(TURBT) was done. Between the former and the latter patients cumulative and multivariate analyses were performed to estabilish predictive factors of pathological recurrence and progression. The resected tumors were immunohistochemically stained with anti-lamin rabbit serum to evaluate the presence or absence of basement membrane breakage, the vascular and/or lymphatic invasion, and to count number of neovascularizasion.
RESULTS
In superficial bladder carcinoma, invasion of basement membrane, grade, invasion of lymphatics and vessels, and neoangiogenesis were significant factors affecting recurrence and progression, and these factors acted independently.
CONCLUSIONS
These factors used to predict recurrence and progression of superficial bladder tumor were thought to be the important risk factors. These results suggested that close follow-up and aggressive treatment such as BCG instillation should be considered for the treatment of superficial bladder cancer with unfavourable prognostic factors.