Identification by quantitative chromatin pattern analysis of patients at risk for recurrence of superficial transitional bladder carcinoma

Purpose: Based on the actual clinical outcomes of 132 fully documented pati ents with superficial transitional cell carcinoma of the bladder, we charac terize the risk of recurrence and/or progression by computer assisted image microscopy applied to Feulgen stained nuclei. Materials and Methods: Each tumor was characterized by the conventional gra ding and staging systems as well as by cytometry generated variables descri bing nuclear DNA content, nuclear morphometry and chromatin patterns. These data were submitted to discriminant analysis to establish a model distingu ishing between 2 groups of patients. Group 1 included cases with remission for more than 60 months and group 2 cases presented with recurrence with or without progression within 12 months of transurethral bladder resection. T his latter model was then validated by Kaplan-Meyer analysis of the full da ta set. Results: As evidenced by Kaplan-Meier analysis, the discriminant factor gen erated by discriminant analysis of cytometry generated variables provided a cutoff value for distinguishing between low and high risks of recurrence ( p < 0.00001), In contrast, conventional grading and staging systems were no t able to make such efficient distinction. Conclusions: These 2 groups can be used as references with which new cases can be compared to prognosticate disease behavior independently of histopat hological grading and/or clinical staging.