Tumour progression and survival in patients with T1G3 bladder tumours: 15-year outcome

Objective To evaluate tumour progression and survival of patients with T1G3 bladder tumours who were followed for 15 years. Patients and methods A subset of 48 patients with T1G3 bladder tumours was entered into a randomized trial of transurethral resection (TUR) or TUR plus bacille Calmette-Guerin (BCG) therapy and followed for a minimum of 15 years. Thirty-nine (81%) patients received one or more courses of BCG. The endpoints of the study were stage progression (defined as muscle invasion or metastasis) and disease-specific survival, Results Of the 48 patients, 25 (52%) progressed and 15 (31%) died from the disease; 33 patients (69%) survived, including 24 (50%) with an intact bladder. The median progression-free survival time was 151 months, Tumour progression occurred in 35% of the patients within the first 5 years, in 16% after 5 - 10 years and in 12% of those followed for 10 - 15 years. Deaths from cancer occurred in 25% of the patients in the first 5 years and in 10% of patients at risk from 5 to 15 years. Conclusions Patients with T1G3 bladder tumours who are treated conservatively are at life-long risk of having a muscle-invasive tumour and dying from bladder cancer.