1983 Volume 74 Issue 5 Pages 798-807
Since it was our impression that overall prognosis of low stage papillary tumors of the bladder is quite favorable, featrues of 94 patients with T1 or less lesion who had been followed and alive for more than 5 years were analyzed to obtain an insight into its natural history.
63 patients (67%) had recurrence. The rate of recurrence was 53.2% at five years and 61.2% at ten years. The numbr of recurrences was one in 32% and more than six in 25%.
The first episode of recurrence took place within six months in 23.8%, within one year in 44.4%, but extremely delayed first recurrence such as later than 5 years after the initial therapy was noted in 20.6%. Patients of frequent recurrence had early recurrence, and the period of recurrence time was short.
In the first recurrence the tumor grade had not progressed from G0, G1 to G2 or more, but this progression of tumor grade occured in 10% at the time of 2nd recurrence, in 21% at the third to fifth recurrence, and in 27% further later. The interval for this change to occur was 3 to 14 years after the initial treatment with a mean of 8.3 years. 3 with more than 6 recurrences died eventually of the progression of the infiltrative disease 6.5 to 14 years after the first admission.
In 8 patients the tumor stage had progressed from T0, T1 to T2 or more in 3 to 14 years after the initial treatment with a mean of 7.7 years. At the time of first recurrence the tumor stage had not progressed but in 18.2% at the time of 2nd recurrence, in 18.7% at the third to fifth recurrence and in 18.7% further later and 3 patients eventually died.
The number of tumors was relevant to recurence rate, bacause multiple tumor has a higher recurrence rate than solitary tumor, 80% and 58.9% respectively. The recurrence rate was 71.2% with TUR and 53.8% with partial cystectomy.
