Objective: This study is assigned to evaluate factors associated with tumor recurrence in patients with superficial transitional cell carcinoma (TCC) of bladder in Sardjito General Hospital Yogyakarta. Material & methods:A prospective observational study design is conducted to evaluate patients with T1 TCC of bladder between 2011 and 2012. Inclusion criteria was patients with T1 TCC of bladder from pathological report. The independent variables are ages, hemoglobin, albumin, creatinine level, urine cytology, tumor grade, tumor diameter, number of tumor, and intravesical chemotherapy. The outcome measure is tumor recurrence during cystoscopy at 3, 6, 9, and 12 month after first resection. This study used chi-square and logistic regression analysis as statistical methods with p < 0.05 and a = 5% are considered significant. All analyses were performed with SPSS statistical software, version 20.0. Result: Sixty-two patients were participated in this study with mean age 60.62 ± 12.15 years. There were 32 patients (51.6%) who had tumour recurrence during first year that need to be resected. Of these patients, 9 patients (14.5%) had tumour recurrence more than one time during first year. In multivariate analysis, factors associated with tumour recurrence were tumour grade (p = 0.041, CI = 0.008-0.908), number of tumor (p = 0.003, CI = 0.003-0.293), and intravesical chemotherapy (p = 0.022, CI = 0.015-0.719). Conclusion: Degree of tumor differentiation, number of tumor and intravesical chemotherapy are factors affecting recurrence of stage 1 transitional cell carcinoma of the bladder.
superficial transitional cell carcinoma, recurrence
Babjuk M, Bohle A, Burger M, Comperat E, Kaasinen E, Palou J, et al. Guidelines on non-muscle-invasive bladder cancer (Ta, T1, and Cis) [Internet]. European Association of Urology Guidelines 2015 edition; 2014 [Cited 2015 May 12). Available from: http://uroweb.org/guideline/non-muscle-invasive-bladder-cancer/.
Jones JS, Larchian WA. Non-muscle-invasive bladder cancer (Ta, T1, and Cis), In Wein AJ, Kavoussi LR, Novick AC, Partin AW, Peters AC, editor. Campbell-Walsh Urology 10th edition. Philadelphia: Saunders Elsevier; 2012. p. 2335-54.
Sylvester RJ, Van der Meijden AP, Oosterlinck W, Witjes JA, Bouffioux C, Denis L, et al. Predicting recurrence and progression in individual patients with stage Ta, T1 bladder cancer using EORTC risk tables: a combined analysis of 2596 patients from seven EORTC trials. Eur Urol. 2006; 49(3): 466-5. http://www.ncbi.nlm.nih.gov/pubmed/16442208
Sylvester RJ, Oosterlinck W, van der Meijden AP. A single immediate postoperative instillation of chemotherapy decreases the risk of recurrence in patients with stage Ta T1 bladder cancer: a meta-analysis of published results of randomized clinical trials. J Urol. 2004; 171: 2186-90. http://www.ncbi.nlm.nih.gov/pubmed/15126782
Perlis N, Zlotta AR, Beyene J, Finelli A, Fleshner NE, Kulkarni GS. Immediate post-transurethral resection of bladder tumor intravesical chemotherapy prevents non-muscle-invasive bladder cancer recurrences: an updated meta-analysis on 2548 patients and quality of evidence review. Eur Urol. 2013; 64(3): 421-30. http://www.ncbi.nlm.nih.gov/pubmed/23830475
Kaasinen E, Rintala E, Hellstrom P, Viitanen J, Juusela H, Rajala P, et al. Factors explaining recurrence in patients undergoing chemo-immunotherapy regimens for frequently recurring superficial bladder carcinoma. Eur Urol. 2002; 42(2): 167-74.