Clinical outcome of tumor recurrence for Ta, T1 non-muscle invasive bladder cancer from the data on registered bladder cancer patients in Japan: 1999-2001 report from the Japanese Urological Association

• Published in: International journal of urology 2009-03, Vol.16 (3), p.279-286
• Main Authors: Kikuchi, Eiji, Fujimoto, Hiroyuki, Mizutani, Yoichi, Okajima, Eijiro, Koga, Hiroshi, Hinotsu, Shiro, Shinohara, Nobuo, Oya, Mototsugu, Miki, Tsuneharu
• Format: Article
• Language: English
• Subjects: Administration, Intravesical; Adult; Aged; Aged, 80 and over; BCG Vaccine - therapeutic use; bladder; carcinoma; Carcinoma, Transitional Cell - mortality; Carcinoma, Transitional Cell - pathology; Carcinoma, Transitional Cell - therapy; Cause of Death; Chemotherapy, Adjuvant; Combined Modality Therapy; Cystectomy - methods; Databases, Factual; Female; Humans; Japan; Kaplan-Meier Estimate; Logistic Models; Male; Middle Aged; Muscle, Smooth - pathology; Neoplasm Invasiveness - pathology; Neoplasm Recurrence, Local - mortality; Neoplasm Recurrence, Local - pathology; Neoplasm Recurrence, Local - therapy; Neoplasm Staging; non-muscle invasive; Probability; Prognosis; Proportional Hazards Models; recurrence; Registries; Risk Assessment; Societies, Medical; Statistics, Nonparametric; Survival Analysis; transitional cell; Treatment Outcome; Urinary Bladder Neoplasms - mortality; Urinary Bladder Neoplasms - pathology; Urinary Bladder Neoplasms - therapy; Young Adult
• ISSN: 0919-8172; 1442-2042
• DOI: 10.1111/j.1442-2042.2008.02235.x

Objective:  To characterize the clinical outcome in a large contemporary series of Japanese patients with newly diagnosed Ta, T1 non‐muscle invasive bladder cancer who underwent transurethral bladder tumor resection with or without intravesical chemotherapy or Bacillus Calmette‐Guérin (BCG) therapy. Methods:  We developed a database incorporating newly diagnosed non‐muscle invasive bladder cancer data and outcomes from a Japanese bladder cancer registry between 1999 and 2001 and identified a study population of 3237 consecutive patients who had complete data based on pathological features. Median patient age was 69.9 years. Results:  The 1‐year, 3‐year, and 5‐year overall recurrence‐free survival rates were 77.0%, 61.3%, and 52.8%, respectively. In multivariate analyses, the multiplicity of bladder tumors, tumor size greater than 3 cm, pathological stage T1, tumor grade G3, and the absence of adjuvant intravesical instillation were independent risk factors for tumor recurrence. Overall, 1710 patients (52.8%) received intravesical instillation; chemotherapy in 1314 (76.8%) and BCG treatment in 396 (23.2%). In patients treated with intravesical chemotherapy in which an anthracycline chemo‐agent was used in 90.5% of the cases, multivariate analyses demonstrated that male gender, multiple bladder tumors, a tumor size greater than 3 cm, and pathological stage T1 were associated with tumor recurrence. Conclusions:  The accumulation and analysis of data from the Japanese National Bladder Cancer Registry made it possible to determine the clinical characteristics, management trends, and survival rates for the period studied. Further study with a dataset created from longer follow‐up data would be warranted to analyze tumor progression and disease survival.