Upper tract tumors in patients with primary bladder cancer followed for 15 years

Purpose: We evaluated the long-term incidence of upper tract tumors in patients with primary superficial bladder cancer. Materials and Methods: A total of 86 patients with stages Ta, T1 and Tis bladder tumors, who were entered into a prospective trial of bacillus Calmette-Guerin between 1978 and 1981, was followed for 15 years or longer. Results: Of the 86 patients 18 (21%) had upper tract tumors after a median interval of 7.3 years (range 1 to 15). Tumors occurred within 5 years of followup in 6 cases, between 5 and 10 years in 7, and between 10 and 15 years in 5. The majority of cancers were invasive and 7 patients died of upper tract tumors. Conclusions: Patients with primary bladder tumors are at risk for upper urinary tract disease for up to 15 years, which suggests the need for lifelong regular upper tract monitoring in these cases.