Division of Urology, Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden.
Urology. 2012 Sep;80(3):625-31. doi: 10.1016/j.urology.2012.04.049.
To evaluate the effect of the bladder wash cytology finding at the primary diagnosis of Stage Ta-T1 urinary bladder cancer on recurrence and progression.
The clinical and pathologic characteristics of all patients with primary Stage Ta-T1 urinary bladder cancer were prospectively registered. The data were divided according to the bladder wash cytology results at diagnosis. Multivariate analyses were performed to determine the influence of bladder wash cytology on recurrence and progression.
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%). High-grade malignant bladder wash cytology was predictive for recurrence and progression (P < .001 and P = .036, respectively). Other factors affecting recurrence were missing bladder wash cytology data, tumors size 16-30 mm and >30 mm, Stage T1 tumor category, and multiplicity (P = .008, P = .006, P < .001, P = .002, and P < .001, respectively). Progression was also associated with T1 tumor category, local recurrence, and primary concomitant carcinoma in situ (P < .001, P < .001, and P = .024, respectively).
High-grade malignant bladder wash cytology at the primary diagnosis was predictive for recurrence and progression. This could be taken into account in designing future follow-up schedules.
评估原发性 Ta-T1 期膀胱癌初诊时膀胱冲洗细胞学检查结果对复发和进展的影响。
前瞻性登记所有原发性 Ta-T1 期膀胱癌患者的临床和病理特征。根据初诊时膀胱冲洗细胞学检查结果对数据进行分组。采用多变量分析确定膀胱冲洗细胞学检查对复发和进展的影响。
分析纳入了 768 例可评估患者，平均随访 60 个月。478 例（62%）患者复发，71 例（9%）患者进展。高级别恶性膀胱冲洗细胞学检查可预测复发和进展（P<0.001 和 P=0.036）。其他影响复发的因素包括未行膀胱冲洗细胞学检查、肿瘤大小为 16-30mm 和>30mm、T1 期肿瘤类别和多发性（P=0.008、P=0.006、P<0.001、P=0.002 和 P<0.001）。进展还与 T1 期肿瘤类别、局部复发和原发性同时原位癌有关（P<0.001、P<0.001 和 P=0.024）。
原发性 Ta-T1 期膀胱癌中高级别恶性膀胱冲洗细胞学检查可预测复发和进展。这可以在设计未来的随访计划时考虑在内。
