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Management of Low Grade Papillary Bladder Tumors

2007; Lippincott Williams & Wilkins; Volume: 178; Issue: 4 Linguagem: Inglês

10.1016/j.juro.2007.05.148

1527-3792

Harry W. Herr, S. Machele Donat, Victor E. Reuter,

Urological Disorders and Treatments

No AccessJournal of UrologyAdult urology1 Oct 2007Management of Low Grade Papillary Bladder Tumorsis accompanied byBladder Cancer: Improving Care With Better Classification and Risk Stratification Harry W. Herr, S. Machele Donat, and Victor E. Reuter Harry W. HerrHarry W. Herr More articles by this author , S. Machele DonatS. Machele Donat More articles by this author , and Victor E. ReuterVictor E. Reuter More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2007.05.148AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: We evaluated the management and treatment outcomes of low grade papillary bladder tumors. Materials and Methods: We evaluated 215 patients diagnosed with low grade and noninvasive papillary bladder tumors, and followed them every 6 months with flexible cystoscopy for 6 to 10 or more years. Tumor recurrence was treated with transurethral resection or outpatient cystoscopic fulguration. Results: Of the 215 patients 143 (67%) had at least 1 recurrence (positive cystoscopy). With a median followup of 8 years tumor recurrences averaged 6.2 (range 1 to 19) requiring 0.34 transurethral resections per year or 1 transurethral resection every 3 years, or 0.61 fulgurations or 1 fulguration approximately every 2 years. There were 17 patients (8%) who had progression in grade or stage and 1 patient (0.5%) died of bladder cancer. Patients most likely to have recurrence had multiple tumors, low grade (TaLG) carcinoma or tumor at first followup cystoscopy. Conclusions: Surveillance cystoscopy at 6-month intervals coupled with outpatient fulguration controls recurrent tumors and reduces the therapeutic burden for patients diagnosed with low grade papillary bladder tumors. References 1 : Comparison of bladder cancer outcome in men undergoing hematuria home screening versus those with standard clinical presentations. Urology1995; 45: 387. Crossref, Medline, Google Scholar 2 : Bladder cancer: Clinical guidelines in oncology. J Natl Compr Canc Netw2006; 4: 984. Google Scholar 3 Konety BR, Joyce GF and Wise M: Bladder and upper tract urothelial cancer. In: Urological Diseases in America. Edited by MS Litwin and CS Saigal. US Department of Health and Human Services, Public Health Service, National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases. Washington, DC: US Government Publishing Office 2007; NIH Publication No. 07-5512, pp 265. Google Scholar 4 : The World Health Organization/International Society of Urological Pathology consensus classification of urothelial (transitional cell) neoplasms of the urinary bladder. Am J Surg Pathol1998; 22: 1435. Google Scholar 5 : Efficacy of office fulguration for recurrent low grade papillary bladder tumors less than 0.5 cm. J Urol2004; 171: 636. Link, Google Scholar 6 : A critical appraisal of the classification of urothelial tumors: time for a review of the evidence and a radical change?. BJU Int2007; 99: 723. Google Scholar 7 : Recurrence and progression in low grade papillary urothelial tumors. J Urol1999; 162: 702. Link, Google Scholar 8 : Low-grade Ta (noninvasive) urothelial carcinoma of the bladder. Urology2005; 66: 75. Google Scholar 9 : Variability in the recurrence rate at first follow-up cystoscopy after TUR in stage TaT1 transitional cell carcinoma of the bladder: a combined analysis of seven EORTC studies. Eur Urol2002; 41: 523. Google Scholar 10 : One immediate postoperative instillation of chemotherapy in low risk Ta, T1 bladder cancer: Is it always safe?. Eur Urol2004; 46: 336. Google Scholar 11 : A single immediate postoperative instillation of chemotherapy decreases the risk of recurrence in patients with stage TaT1 bladder cancer: a meta-analysis of published results of randomized clinical trials. J Urol2004; 171: 2186. Link, Google Scholar 12 : Use of urinary biomarkers for bladder cancer surveillance: patient perspectives. J Urol2007; 177: 1277. Link, Google Scholar Departments of Urology and Pathology, Memorial Sloan-Kettering Cancer Center, New York, New York© 2007 by American Urological AssociationFiguresReferencesRelatedDetailsCited byStröck V and Holmäng S (2015) A Prospective Study of the Size, Number and Histopathology of New and Recurrent Bladder TumorsUrology Practice, VOL. 2, NO. 5, (260-264), Online publication date: 1-Sep-2015.Mostafid H, Kirby R, Fitzpatrick J and Bryan R (2014) The Safe and Economical Care of Ta Bladder CancerUrology Practice, VOL. 1, NO. 4, (176-183), Online publication date: 1-Nov-2014.Pellucchi F, Freschi M, Ibrahim B, Rocchini L, Maccagnano C, Briganti A, Rigatti P, Montorsi F and Colombo R (2011) Clinical Reliability of the 2004 WHO Histological Classification System Compared With the 1973 WHO System for Ta Primary Bladder TumorsJournal of Urology, VOL. 186, NO. 6, (2194-2200), Online publication date: 1-Dec-2011.Herr H (2007) Low Risk Bladder Tumors—Less is More!Journal of Urology, VOL. 179, NO. 1, (13-14), Online publication date: 1-Jan-2008.Related articlesJournal of Urology15 Aug 2007Bladder Cancer: Improving Care With Better Classification and Risk Stratification Volume 178Issue 4October 2007Page: 1201-1205 Advertisement Copyright & Permissions© 2007 by American Urological AssociationKeywordsurinary bladder neoplasmscarcinoma, papillaryMetrics Author Information Harry W. Herr More articles by this author S. Machele Donat More articles by this author Victor E. Reuter More articles by this author Expand All Advertisement PDF downloadLoading ...