INTRAVESICAL THERAPY IN SUPERFICIAL BLADDER-CANCER

Objective. To identify the appropriate characteristics of superficial bladder cancer that allow the physician to predict tumor behavior. Met hods. We analyzed 1,745 patients with primary superficial bladder canc er with regard to disease and patient characteristics. Results. With t he characteristics we found, the population can be described and progn ostic factors can be found. Moreover, with the use of these factors, i t appears to be possible to predict tumor behavior on a group level. P rediction on an individual level, however, remains far from ideal. Con clusions. Three treatment options can be chosen: follow-up after initi al transurethral resection, additional instillations with intravesical chemotherapy, or instillations with bacillus Calmette-Guerin (BCG). I n case instillations are indicated, most (but not all) superficial bla dder cancer trials show superiority of BCG over intravesical chemother apy, although at the cost of more side effects. However, with intraves ical BCG, it seems possible to influence the natural history of superf icial bladder cancer, which means that we can delay progression and im prove survival.