Impact of tumour size on recurrence and progression in Ta/T1 carcinoma of the urinary bladder.

OBJECTIVE

This study aimed to evaluate the impact of tumour size on recurrence and progression in a population-based series of non-muscle-invasive bladder cancers.

MATERIAL AND METHODS

Clinical and pathological characteristics of patients with primary Ta/T1 bladder cancer were registered. The patients' tumours were categorized by size into five size groups (1-10, 11-20, 21-30, 31-40 and >40 mm) or three size groups (1-15, 16-30 and >30 mm).

RESULTS

The analysis included 768 evaluable patients with a mean follow-up of 60 months. Recurrence was observed in 478 patients (62%) and progression in 71 (9%). Tumour size was associated with recurrence for tumours sized 21?30, 31?40 and >40 mm (p = 0.03, p < 0.001, p < 0.001, respectively) in the five size group and for tumours sized 16?30 and >30 mm (p = 0.003 and p < 0.001) in the three size group. Other factors affecting recurrence were T1 tumour category, multiplicity and surgery performed by residents (p < 0.001, p < 0.001, p = 0.002, respectively). Considering progression, there was no significant association with tumour size, and T1 category and local recurrence were the only significant risk factors (both p < 0.001).

CONCLUSION

Tumour size ?15 mm is associated with a lower risk of recurrence but not progression. Dividing tumour size into three size groups gives additional information compared with two size groups with cut-off at 30 mm.