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MANAGEMENT OF SUPERFICIAL BLADDER CANCER IN VICTORIA: 1990 AND 1995
Author(s) -
Frydenberg Mark,
Millar Jeremy L.,
Toner Guy,
Bolton Damien,
Syme Rodney,
Thursfield Vicky J.,
Giles Graham G.
Publication year - 2005
Publication title -
anz journal of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.426
H-Index - 70
eISSN - 1445-2197
pISSN - 1445-1433
DOI - 10.1111/j.1445-2197.2005.03347.x
Subject(s) - medicine , bladder cancer , general surgery , cancer
Background: A retrospective survey of medical practitioners was undertaken to describe the tumour characteristics, management and outcomes of all superficial bladder cancers newly diagnosed in 1990 and in 1995 in Victoria. Methods: Cases were identified from the population cancer registry. The survey was conducted in 1999 and the cohort followed up until 2000 to obtain at least 5 years of follow‐up data on all patients, in particular to identify recurrence of tumour as assessed at surveillance cystoscopy and progression to muscle invasive cancer. Results: Tumour recurrence was observed in 390/610 patients (63.9%), of whom 56.9% had their recurrence noted at the first check cystoscopy. Ultimately 43 (6.3%) of patients progressed to invasive disease, with this subgroup demonstrating 5‐year overall survival of 35% (95% confidence interval (CI) 21–49%). Ultimately survival was proportional to the extent of tumour invasion, being greater in low‐risk patients (76%, 95% CI 72–80%, mucosal disease only) than in high‐risk patients (46%, 95% CI 36–56%, lamina propria invasion noted at diagnosis). Conclusions: In low‐risk subgroups of patients with superficial transitional cell carcinoma, the frequency of surveillance cystoscopy may be able to be reduced to levels in accordance with established European guidelines without a likely impact on patient survival. Where progression to muscle invasive disease does ensue, more aggressive management may be warranted in order to try to improve survival.