Rationale for intensive intravesical chemotherapy for superficial bladder cancer

The high incidence of vesical tumors after initial management of a superficial tumor (stages 0 and A) presents a major therapeutic challenge to the urologist. This incidence of subsequent tumors ranges from 40 to 70 per cent and is consistent among several series. Most of these tumors will occur within 6 to 12 months. I herein review some factors accounting for this high incidence and suggest a therapeutic strategy that might delay or prevent these rapid recurrences.