Catto - Figure 20

Low risk NMI: Death

FIG. 20:  This Figure shows similar results from a study of data from patients who were treated in Sheffield for low-risk disease.[22]  Out of 3633 new primary bladder cancers, 699 were low-grade non-muscle-invasive (G1pTa) tumors (which in the 1973 WHO criteria in use in the UK at the time these were classified as Grade I[16]).  The diagnoses were annotated by clinical outcome, with a median follow-up of 61 months. 

Almost one third (28.5;%) of these patients’ tumors had a local recurrence at a median of 13.5 months.  Metastasis or progression to invasive tumor occurred in 2.6% of patients and high-grade progression developed in 4.7% of patients.  Survival was excellent in these low-risk patients, with the cancer-specific mortality of 2.4% at 55 months  However these were patients with competing risks such as heavy smoking and occupational exposure, so many developed cardiopulmonary disease, and as seen in Panel D, overall mortality was 34.6%, meaning that many patients were dying of other causes. 

References

[16]

Mostofi FK, Sobin LH, Torloni H. Histological typing of urinary bladder tumours. Geneva, Switzerland: World Health Organization; 1973

[22]

Linton KD, Rosario DJ, Thomas F, et al. Disease specific mortality in patients with low risk bladder cancer and the impact of cystoscopic surveillance. J Urol. 2013;189:828−33  https://doi.org/10.1016/j.juro.2012.09.084