The treated natural history of high risk superficial bladder cancer

15- year outcome

Michael S. Cookson, Harry W. Herr, Zuo Feng Zhang, Scott Soloway, Pramod C. Sogani, William R. Fair

Research output: Contribution to journalArticle

420 Citations (Scopus)

Abstract

Purpose: The long term outcome of patients with high risk superficial bladder cancer is unknown. We report the results of 15 years of followup of high risk patients treated initially with aggressive local therapy, including transurethral resection alone or combined with in travesical bacillus Calmette-Guerin. Materials and Methods: Between 1978 and 1981, 86 high risk patients enrolled in a randomized study of transurethral resection alone or with intravesical bacillus Calmette-Guerin for superficial bladder cancer. Of these patients 81% had diffuse carcinoma in situ and 44% had stage T1 tumors before entry into the study. Patients were followed until death (61%) or until the present time (median followup 184 months). Results: Disease stage progressed in 46 patients (53%) and 31 (36%) eventually underwent cystectomy for progression (28) or refractory carcinoma in situ (3), while 18 (21%) had upper tract tumors at a median of 7.3 years. The 10 and 15-year disease specific survival rates were 70 and 63%, respectively. At 15 years 34% of patients overall were dead of bladder cancer, 27% were dead of other causes and 37% were alive, including 27% with an intact functioning bladder. Conclusions: Despite aggressive local therapy patients with high risk superficial bladder cancer are at lifelong risk for development of stage progression and upper tract tumors. A third of patients are at risk for death from bladder cancer, justifying careful and vigilant long term follow up. These results support the use of initial aggressive local therapy in patients with high risk superficial bladder cancer.

Original languageEnglish
Pages (from-to)62-67
Number of pages6
JournalJournal of Urology
Volume158
Issue number1
DOIs
StatePublished - Jul 1 1997
Externally publishedYes

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Natural History
Urinary Bladder Neoplasms
Carcinoma in Situ
Mycobacterium bovis
Neoplasms
Cystectomy
Urinary Bladder
Therapeutics
Survival Rate

Keywords

  • BCG vaccine
  • Bladder neoplasms
  • carcinoma in situ

ASJC Scopus subject areas

  • Urology

Cite this

Cookson, M. S., Herr, H. W., Zhang, Z. F., Soloway, S., Sogani, P. C., & Fair, W. R. (1997). The treated natural history of high risk superficial bladder cancer: 15- year outcome. Journal of Urology, 158(1), 62-67. https://doi.org/10.1097/00005392-199707000-00017

The treated natural history of high risk superficial bladder cancer : 15- year outcome. / Cookson, Michael S.; Herr, Harry W.; Zhang, Zuo Feng; Soloway, Scott; Sogani, Pramod C.; Fair, William R.

In: Journal of Urology, Vol. 158, No. 1, 01.07.1997, p. 62-67.

Research output: Contribution to journalArticle

Cookson, MS, Herr, HW, Zhang, ZF, Soloway, S, Sogani, PC & Fair, WR 1997, 'The treated natural history of high risk superficial bladder cancer: 15- year outcome', Journal of Urology, vol. 158, no. 1, pp. 62-67. https://doi.org/10.1097/00005392-199707000-00017
Cookson, Michael S. ; Herr, Harry W. ; Zhang, Zuo Feng ; Soloway, Scott ; Sogani, Pramod C. ; Fair, William R. / The treated natural history of high risk superficial bladder cancer : 15- year outcome. In: Journal of Urology. 1997 ; Vol. 158, No. 1. pp. 62-67.
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