Original Article: Clinical Investigation
Clinical outcome of high-grade non-muscle-invasive bladder cancer: A long-term single center experience
Article first published online: 4 FEB 2009
© 2009 The Japanese Urological Association
International Journal of Urology
Volume 16, Issue 3, pages 287–292, March 2009
How to Cite
Iida, S., Kondo, T., Kobayashi, H., Hashimoto, Y., Goya, N. and Tanabe, K. (2009), Clinical outcome of high-grade non-muscle-invasive bladder cancer: A long-term single center experience. International Journal of Urology, 16: 287–292. doi: 10.1111/j.1442-2042.2008.02239.x
- Issue published online: 11 MAR 2009
- Article first published online: 4 FEB 2009
- Received 22 April 2008; accepted 24 November 2008.; Online publication 4 February 2009
- clinical outcome;
- concomitant CIS;
- high-grade (G3);
- non-muscle-invasive bladder cancer (NMIBC)
Objectives: To report on the long-term clinical outcome of high-grade (G3) non-muscle-invasive bladder cancer (NMIBC) patients treated at a single institution.
Methods: A retrospective analysis of 93 patients with NMIBC treated between January 1991 and September 2005 was performed. Patients were divided into three groups on the basis of treatment they received after transurethral resection (TUR) of the bladder. Forty-seven patients received adjuvant intravesical epirubicine after TUR of the bladder (Group 1). Twenty-four patients received intravesical bacillus Calmette–Guérin (BCG) (Group 2). A radical cystectomy (RC) was performed on twenty-two patients (Group 3).
Results: Median follow up was 68.7 months. Overall, thirty patients (33%) experienced tumor recurrence. The survival rates of Group 3 were significantly higher than the 71 patients undergoing conservative therapy (Group 1 and 2). There was no statistically significant difference between Group 1 and 2, but treatment failure in patients treated with epirubicine was significantly higher than in those with BCG. Cases without concomitant carcinoma in situ (CIS) showed statistically significantly higher survival rates than those with concomitant CIS.
Conclusions: RC provides excellent survival rates in patients with high-grade NMIBC. Adjuvant therapy with BCG after a complete TUR of the bladder may be an effective treatment for high-grade NMIBC. If a conservative treatment is preferred to RC, co-existence of a concomitant CIS should be considered with caution.