You have accessJournal of UrologyBladder Cancer: Superficial1 Apr 20111739 FREQUENCY OF TUMOR RECURRENCE: A STRONG PREDICTOR OF STAGE PROGRESSION IN INITIALLY DIAGNOSED NONMUSCLE INVASIVE BLADDER CANCER Nobuyuki Tanaka, Eiji Kikuchi, Kazuhiro Matsumoto, Akira Miyajima, Ken Nakagawa, and Mototsugu Oya Nobuyuki TanakaNobuyuki Tanaka Tokyo, Japan More articles by this author , Eiji KikuchiEiji Kikuchi Tokyo, Japan More articles by this author , Kazuhiro MatsumotoKazuhiro Matsumoto Tokyo, Japan More articles by this author , Akira MiyajimaAkira Miyajima Tokyo, Japan More articles by this author , Ken NakagawaKen Nakagawa Tokyo, Japan More articles by this author , and Mototsugu OyaMototsugu Oya Tokyo, Japan More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2011.02.2066AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Patients with nonmuscle invasive bladder cancer (NMIBC) usually experience multiple instances of tumor recurrence until stage progression occurs. Several papers have evaluated the prognostic impact of tumor recurrence by itself (i.e. primary versus recurrent) on subsequent stage progression in NMIBC, however, while short-term followup periods of less than 5 years have been reported, few papers have estimated accurately the prognostic impact of the timing and/or pattern of tumor recurrence for long-term courses. Using our long-term followup data, we examined whether the frequency of tumor recurrence (FTU) provides additional predictive information concerning stage progression. METHODS A total of 484 patients with initially diagnosed NMIBC were identified between 1985 and 2006 at our institution. Median followup was 7.2 years. FTR was analyzed to determine if it affected subsequent stage progression. RESULTS Of these patients 40 (8.3%) experienced stage progression during followup. Kaplan-Meier analysis according to various recurrence rates in each cutoff period after initial TUR-BT demonstrated that patients with a recurrence rate ≥ 1/year during the first 2 years could be most strongly predicted to have subsequent stage progression (p<0.001), while similar results were observed during the first 1 and 3 years. Using the defined parameter of recurrence rate ≥ 1/year during the first 2 years, multivariate analysis demonstrated that the appearance of tumor grade 3 (p= 0.027, risk ratio 2.36), carcinoma in situ (p= 0.045, risk ratio 2.44), and a recurrence rate ≥ 1/year during the first 2 years (p<0.001, risk ratio 7.40) were independent risk factors for subsequent stage progression. The 10-year progression-free survival rate was 58.0% in patients with a recurrence rate ≥ 1/year during the first 2 years and 93.3% in their counterparts (p<0.001). To clarify whether FTR provided additional information compared with the presence of tumor recurrence by itself, multivariate analysis demonstrated that the presence of tumor recurrence in the first 2 years was also an independent predictor for subsequent stage progression (HR: 3.37, range: 1.65–6.91), however still the hazard ratio for a recurrence rate ≥ 1/year during the first 2 years was higher. CONCLUSIONS FTR is a strong predictor of subsequent stage progression in patients initially diagnosed with NMIBC. More appropriate followup and aggressive treatment due to a higher risk for stage progression might be recommended in patients with recurrence rate ≥ 1/year during the first 2 years. © 2011 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 185Issue 4SApril 2011Page: e698 Advertisement Copyright & Permissions© 2011 by American Urological Association Education and Research, Inc.MetricsAuthor Information Nobuyuki Tanaka Tokyo, Japan More articles by this author Eiji Kikuchi Tokyo, Japan More articles by this author Kazuhiro Matsumoto Tokyo, Japan More articles by this author Akira Miyajima Tokyo, Japan More articles by this author Ken Nakagawa Tokyo, Japan More articles by this author Mototsugu Oya Tokyo, Japan More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...