PROGNOSTIC FACTORS IN NODULAR TRANSITIONAL-CELL BLADDER-TUMORS

A cohort of 106 nodular transitional cell bladder cancers (TCC) were f ollowed up for a mean of 9 years. Clinical stage, WHO grade, six morph ometric nuclear factors and volume corrected mitotic index (M/V index) were correlated to progression and survival during the follow-up peri od. Nuclear factors were related to WHO grade with a borderline signif icance (p=0.01-0.3) whereas the M/V index showed a highly significant relation to WHO grade. Neither nuclear factors nor the M/V index were related significantly to T-, N- or M-categories at the time of diagnos is. Progression in N- and M-categories was related independently to WH O grade whereas progression in T-category could not be predicted signi ficantly by none of the variables included in this analysis. Survival was predicted by T-category (p=0.0028), N-category (p=0.0001), M-categ ory (p=0.0057) and M/V index (p=0.010). In T1-T2N0M0 tumours survival was predicted by the Dmax (p=0.015) and by the M/V index (p=0.039). In multivariate survival analysis T-category (p<0.001) had independent p rognostic value. In T1-T2N0M0 tumours only the M/V index predicted sur vival independently (p=0.007). The results show that only the prolifer ation rate in addition to T-category have prognostic significance in n odular TCC.