Superficial bladder cancer: for how long should a tumour‐free patient have check cystoscopies?

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Abstract
Objective To determine the probability of a patient with superficial bladder cancer developing a recurrent tumour after having remained tumour free for 2 or more years. Patients and methods One‐hundred and seventy‐nine patients with Ta or T1 tumours at diagnosis, a minimum follow‐up of 3 years and a minimum of 2 years remaining tumour free were identified. Thirteen patients had more than one episode that was eligible for inclusion and there were therefore 192 tumour‐free episodes for analysis. Survival curves of the probability of being recurrence‐free against time were constructed for the whole group, for subgroups of Ta and T1 tumours and for subgroups with characteristics at diagnosis suggesting a good, intermediate and poor prognosis. Results The probability of a patient developing a recurrence after 2, 5 and 10 years of being tumour free was 43, 22 and 2% respectively. No patient had a recurrence after remaining tumour free for 12 years. No patient who had been tumour free for at least 2 years progressed to muscle invasion or metastases. There was no significant difference in the probability of recurrence between Ta and Tl tumours after 2 years of remaining tumour free. Conclusion The optimum length of cystoscopic follow‐up for patients with superficial bladder cancer is unknown, but patients continue to develop recurrences even after many years of being tumour free. If a patient is to discontinue cystoscopic follow‐up, then alternative methods of assessment should be applied.