Natural History, Recurrence, and Progression in Superficial Bladder Cancer

Abstract

Superficial bladder cancer encompasses patients with stage Ta T1 tumors and patients with carcinomain situ(CIS). The natural history or treatment-related prognosis of these patients varies considerably from one patient to the next based on the patient’s clinical and the tumor's pathological characteristics. Based on a review of the literature, the most important prognostic factors for recurrence are the prior recurrence rate, number of tumors, and tumor size; whereas for progression, the most important prognostic factors are the T category, grade, and presence of CIS. Treatment with intravesical bacillus Calmette-Guerin reduces both the risk of recurrence and the risk of progression, and is the treatment of choice in high-risk papillary tumors and in patients with CIS. Assessment of a patient's prognostic factors and his or her risk of recurrence and progression is a prerequisite for determining the most appropriate treatment and frequency of follow-up for a given patient.