TUMOR PROGRESSION AND SURVIVAL OF PATIENTS WITH HIGH GRADE, NONINVASIVE PAPILLARY (TaG3) BLADDER TUMORS: 15-YEAR OUTCOME

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Abstract
Tumor progression and survival of patients with high grade Ta bladder tumors followed for 15 to 20 years were evaluated. A total of 148 patients with Ta and 73 with T1 multiple, recurrent papillary bladder tumors were evaluated. In all patients complete transurethral resection was performed and 1 or more courses of bacillus Calmette-Guerin therapy were given. Minimum followup was 15 years. Of the Ta tumors 125 were high grade and 23 were low grade. The end points of the study were stage progression, defined as lamina propria invasion, muscle invasion or metastasis, and disease specific survival. The 15-year progression-free survival rate was 95% in the 23 patients with low grade Ta tumors and none died of disease. Progression-free survival and disease specific survival rates were 61% and 74%, respectively, in 125 patients with high grade Ta tumors compared to 44% and 62%, respectively, in 73 with T1 tumors. Patients with high grade Ta tumors have a lifelong risk of disease stage progression and death from bladder cancer similar to those with T1 tumors.