Objectives: We retrospectively evaluated characteristics of T1 high-grade bladder cancer in patients in our hospitals.
Patients and methods: Data was reviewed from 134 patients who were diagnosed with T1 high-grade bladder cancer and who underwent transurethral resection (TUR) in our hospitals between January 2006 and December 2012. The clinical course for each patient, the recurrence and progression rates, and the risk factors for recurrence and progression were evaluated.
Results: The median follow-up was 31.5 months. A second TUR was performed in 55 patients (41.0%), and showed 32 cases of residual tumor (58.2%) and 4 cases of upstaging (7.3%). The recurrence rate was 41.5%. The risk factors for recurrence were (1) no muscle obtained in initial TUR, (2) no BCG, and (3) no second TUR. The progression rate was 10.5%; no significant risk factors were identified for progression. Within the T1 high-grade bladder cancer cohort, a total of 31 patients underwent radical cystectomy (RC). When we graphed cancer-specific survival (CSS) curves stratified by pathological T stage at the time of RC, and then compared findings from the upstage group (greater than pT2) and the non-upstage group (less than pT2), the CSS rate was significantly higher in the non-upstage group (p = 0.0027).
Conclusion: No muscle in initial TUR, no BCG, and no second TUR are factors associated with recurrence of T1 high-grade bladder cancer. Further investigation is needed for preventing recurrence and progression and for improving survival following radical cystectomy in T1 high-grade bladder cancer.