Pk. Lipponen et al., PROLIFERATION INDEXES AS INDEPENDENT PROGNOSTIC FACTORS IN PAPILLARY TA-T1 TRANSITIONAL-CELL BLADDER-TUMORS, British Journal of Urology, 72(4), 1993, pp. 451-457
A cohort of 148 patients with papillary Ta-T1 transitional cell carcin
omas (TCCs) was followed up for over 10 years and flow cytometric (DNA
ploidy, S phase fraction) and morphometric variables (5 nuclear facto
rs, volume corrected mitotic index) were related to prognosis during t
his period. Recurrence-free survival was significantly related to DNA
ploidy, S phase fraction and M/V index. Progression in T-category was
predicted by M/V index, S phase fraction, DNA ploidy and WHO grade. Th
e same variables predicted progression in N- and M-categories. In a mu
ltivariate analysis only M/V index and S phase fraction were independe
nt predictors of progression. Univariate analysis showed that M/V inde
x, SPF, DNA ploidy and WHO grade predicted survival. In a multivariate
survival analysis only M/V index and SPF were independent predictors.
The results showed that proliferation indices had independent prognos
tic value in papillary Ta-T1 TCCs and the grading of these tumours cou
ld be based on the proliferation indices. Papillary Ta-T1 tumours with
a M/V index value less than or equal to 10/mm(2) or SPF less than or
equal to 10% had a favourable prognosis whereas tumours with M/V index
> 10/mm(2) or SPF > 10% had a high malignant potential.