Primary superficial bladder cancer risk groups according to progression, mortality and recurrence

Purpose: We identified risk groups in primary superficial bladder cancer ac cording to progression, mortality and recurrence rates. Materials and Methods: The prognostic factors of progression, mortality and recurrence were identified by multivariate analysis in a cohort of 1,529 p atients with primary superficial bladder cancer. Risk groups were designed by combining the relative risk of these prognostic factors. We performed su rvival analysis of progression, tumor mortality and recurrence by risk grou p using the Kaplan-Meier method. Relative risk in each group was calculated by Cox regression. We present timetables of progression, mortality and rec urrence by risk group. Results: Risk groups were classified as low-grade 1 stage Ta disease and a single grade 1 stage T1 tumor, intermediate-multiple grade 1 stage T1 tumor s, grade 2 stage Ta disease and a single grade 2 stage T1 tumor, and high-m ultiple grade 2 stage T1 tumors, grade 3 stages Ta and T1 disease, and any stage disease associated with carcinoma in situ. Survival analysis of progr ession, mortality and recurrence revealed a statistically significant diffe rence among the 3 risk groups. The rates of recurrence, progression and mor tality were 37%, 0% and 0% in the low, 45%, 1.8% and 0.73% in the intermedi ate, and 54%, 15% and 9.5% in the high risk group, respectively. The relati ve risks of recurrence, progression and mortality in the low versus the int ermediate and high risk groups were 1.37, 2.84 and 1, and 1.87, 24.76 and 1 4.69, respectively. Conclusions: Risk group classification leased on prognostic factors defines progression, mortality and recurrence rates in primary superficial bladder cancer. It may be useful for designing treatment and followup strategies.