THE PROGNOSTIC-SIGNIFICANCE OF VASCULAR INVASION IN STAGE T1 BLADDER-CANCER

Transurethral resection specimens from 170 T1 bladder carcinomas were reviewed for the presence of vascular (blood vessel and/or lymphatic) invasion by tumour cells, Such a finding was noted in 17 cases (10%), and occurred most frequently in high grade tumours, Tumour recurrence was documented in 11 of these cases (65%), including seven patients wh o showed progression to more invasive disease (T2-T4) and six patients (55%) who died of disease, Five-year survival for cases without vascu lar invasion was 81% versus 44% for those with, This was a statistical ly significant difference (log-rank, P = 0.004), Neoplasms of high gra de (grades 2 to 3), without a papillary configuration, and exceeding 5 cm were associated with vascular invasion (chi-squared; P < 0.001, P = 0.043, and P = 0.061 respectively), In multivariate analysis vascula r invasion proved to be an independent prognostic factor (Cox's regres sion, P = 0.015). We therefore stress the clinical relevance of a thor ough evaluation of the state of vascular invasion in stage T1 bladder cancer.