PROLONGING FOLLOW-UP INTERVALS FOR NONINVASIVE BLADDER-TUMORS - A RANDOMIZED CONTROLLED TRIAL

Considerable resources are devoted to the follow-up of patients with s uperficial bladder tumors. Traditionally these patients are evaluated every three months in the first year(s) after the primary resection. I n a randomised controlled design we evaluated the consequences of doub ling the follow-up intervals for patients with non-invasive bladder tu mors (Ta) with none of the following risk factors: concomitant urothel ial dysplasia, tumor grade >II, early recurrence. The patients were al located to one of two follow-up regimens: Regimen I: follow-up every t hree months for the first two years and every six months in the third year, thereafter once a year. Regimen II: Every six months for the fir st year and once a year thereafter At most of the follow-up visits the bladder was examined by transabdominal ultrasound. Cystoscopy was per formed in all patients once a year. The data from the 97 patients were evaluable. Three patients in regimen I and 1 patient in regimen II pr ogressed in grade and/or stage in the observed period. No patient died of his tumor disease. There was no difference with regard to recurren ce, progression and tumor-related death between the two groups. The to tal number of follow-up visits in regimen II was reduced by 37.5% (P=0 .0016) compared to regimen I. The number of patients specific follow-u p visits with a recurrent tumor present was increased by 65% (P=0.0475 ). In the future we will follow this selected group of patients with n on-invasive bladder tumors as described.