Prognosis in Early Carcinoma of the Bladder Based on Chromosomal Analysis

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Abstract
In 53 cases of noninvasive or submucosal invasive well differentiated carcinoma of the bladder observed for 4-101 mo. cytogenetic analysis by the direct technique (nonculture) was performed repeatedly. Abnormal chromosomes, were found in 33 patients and recurrence developed in 32 of these 33 patients, resulting in 9 deaths. All but 1 of the 20 patients without markers were observed for up to 8 yr and remained free of recurrence. In this 1 recurrence, 8 mo. postdiagnosis, the mode changes from 69-92, evidence of dedifferentiation and development of a new tumor in a bladder prone to neoplasia. Based on over-all cytogenetic experience with 165 patients with carcinoma of the bladder a simplified classification is presented. This classification, built on measurable characteristics of early carcinoma, including the presence or absence of marker chromosomes, allows accurate prognostication and provides the foundation for development of standard therapy.