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The impact of regular biopsy in the first cystoscopic follow-up and other predictors on the recurrence of superficial bladder tumors.

BACKGROUND
To evaluate whether cystoscopic evaluations with bladder biopsy can serve as a significant predictor of superficial bladder tumor recurrence.


METHODS
This study examined patients with superficial bladder cancer (Ta/T1). At the first three-month cystoscopic follow-up, subjects were divided into two groups: group 1 received cystoscopic examinations with transurethral bladder biopsy, and group 2 had a cystoscopic examination only. Patients without evidence of recurrence at the first three-month follow-up in these 2 groups (groups 1A and 2A) were compared with respect to recurrence rates and average recurrence time.


RESULTS
One hundred and thirty patients were diagnosed with superficial bladder tumors. The mean follow-up time was 22.9 months. The two-year recurrence rates were 33.8% for Ta, 29.8% for T1, 30.4% for low-grade tumors, 31.9% intravesical for high-grade tumors, 26.4% in those treated with bacillus Calmette-Guerin therapy, 33.4% in those who had chemotherapy, 60% in the non-therapy group, 21.8% for single tumors and 47.9% for multiple tumors. Univariate and multivariate analysis revealed that tumor number and intravesical therapy were important predictive factors for tumor recurrence. The average recurrence times in groups 1A and 2A were 18.3 and 12.6 months, respectively, while the respective one-year/two-year recurrence rates were 2.4%/23.8% and 16.9%/22.1%. Univariate analysis showed no statistically significant differences between these two groups.


CONCLUSIONS
Our data support tumor number and intravesical therapy as important predictive factors for tumor recurrence. Cystoscopy combined with transurethral bladder biopsy mitigates tumor recurrence in the early years, but not in later years. Therefore, regular cystoscopic evaluation alone is sufficient for longterm patient surveillance.