Predictive Value Of The First Follow-up Cystoscopy After TUR-BT To The Recurrence And Progression Of Non-muscle-invasive Bladder Cancer

Objective: To review the findings at the first follow-up cystoscopy in patients withnon-muscle-invasive bladder cancer and to investigate the predictive value to therecurrence and progression.Methods: A retrospective study was done on192patients with primary stage Taand T1bladder cancers treated between October1990and February2002, results at thefirst follow-up cystoscopy, recurrence and progression characters were recorded d-uring follow-up and to analyse the predictive value of the first follow-up cystoscopy tothe recurrence and progression.Results: During5years follow-up, the recurrence rate of positive and negativefirst cystoscopy respectively was52.9%and32.3%(P=0.023), the progression rate re-spectively was35.5%and14.6%(P=0.047). The recurrence rate of single and mu-ltiple tumors respectively was28.3%and50.8%(P=0.002), the progression raterespectively was14.96%and18.46%(P=0.533). The recurrence rate of Ta and T1stage tumors respectively was30.13%and54.3%(P=0.003), the progression raterespectively was8.2%and41.3%(P <0.001). The recurrence rate of papillary ur-othelial neoplasms of low and high malignant potential respectively was38.58%and62.96%(P=0.051), the progression rate respectively was14.3%and51.9%(P <0.001). The Cox proportional hazard regression model shows the results that firstcystoscopy findings,the number of the tumours and stage had prognostic significancefor time to recurrence(P<0.05),but the grade had no influence to tumour recurrence ofthe non-muscle-invasive bladder cancer (P<0.05). The first cystoscopy findings, gradeand stage had prognostic significance for time to stage progression(P<0.05),but thenumber of the tumours had no influence to tumour progression of non-muscle-inv- asive bladder cancer (P<0.05). On multivariate analysis the first cystoscopy findingshad Important influence to progression and recurrence of non-muscle-invasive bla-dder cancer. The tumour recurrence HR value was2.813(P=0.0165) and the tumourprogression HR value was3.615(P=0.002). The progression rate and the recurrencerate of the high grade and multiple tumors with negative first cystoscopy respectivelywas36.4%and35.6%. The progression rate and the recurrence rate of all tumourwith positive first cystoscopy respectively was29.4%and52.9%. The progression rateand the recurrence rate of the high grade and multiple tumors with positive firstcystoscopy respectively was100%and65%.Conclusion: Results of the first follow-up cystoscopy after TUR-BT have thepredictive value of the recurrence and progression of non-muscle-invasive bladdercancer, which combining with other tumor biological behavior characteristi-cs such ashigh grade and multiple tumors can increase the accuracy of tumor recurrence andprogression.