Pattern of Recurrence Changes in Noninvasive Bladder Tumors Observed During 2 Decades

PurposePreviously published data on the 25-year outcome of G1Ta and G2Ta bladder tumors demonstrated that both tumors have a similarly low risk of recurrence in cases in which no tumor was detected in the first 5 years after presentation. A further 4 prospectively maintained cohorts were available for comparison between institutions or across time periods.Materials and MethodsReview of a prospectively kept, computerized record of patients with bladder cancer allowed analysis of the long-term outcome of 4 further cohorts of bladder cancer presenting in 1978 to 1986 or 1991 to 1996.ResultsA total of 325 patients with G1Ta and 190 with G2Ta bladder tumors had up to 25 years of followup. The risk of recurrence in the first 5 years was identical in all cohorts from the 1980s. However, in those patients without recurrence in the initial 5 years, the subsequent risk of recurrence (in G1 and G2Ta tumors) was 3.2% in the earlier cohorts but increased 3-fold to 10.8% in the cohorts from the early 1990s (RR 3.3, 95% CI 1.2–9.5, p = 0.016).ConclusionsA difference was observed in the pattern of late biopsy proven recurrence in the more contemporary cases. Increased use of prophylactic intravesical chemotherapy does not seem to be a strong factor. Changes in the ability to detect lesions and the readiness to biopsy suspicious lesions may be responsible for this difference.