Predictors Of Stage Progression In Initially Diagnosed Nonmuscle Invasive Bladder Cancer

Objectlve: To evaluate the prognostic factors affecting stage progressions of patientswith Nonmuscle Invasive Bladder Cancer.Materials and Methods: A total of293patients with initially diagnosed non-muscleinvasive bladder cancer were identified between2000and2009at Friendship affiliatedhospital of Dalian Medical University. Median followup was75.3months. Frequency oftumor recurrence was analyzed to determine if it affected subsequent stage progression.Results: Of these patients40(15.4%) experienced stage progression during fol-lowup.Using Kaplan-Meier analysis subsequent stage progression could be most stronglypredicted in patients with a recurrence rate of1or more per year during the first2years,although similar results were observed for various cutoff periods and recurrence rates.The10-year progression-free survival rate was58.0%in patients with a recurrence rateof1or more per year and93.3%in their counterparts (p＜0.001). Multivariate analysisdemonstrated that the appearance of tumor grade3, carcinoma in situ and a recurrencerate of1or more per year during the first2years were independent risk factors forsubsequent stage progression.Conclusions: Frequency of tumor recurrence is a strong predictor of subsequent stageprogression in patients initially diagnosed with nonmuscle invasive bladder cancer.More appropriate followup and aggressive treatment due to a higher malignant potentialfor stage progression might be recommended in patients with a recurrence rate of1ormore per year during the first2years.