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N34 The evaluation of recurrence rates within the first year for Ta T1 low and intermediate transitional cell carcinoma of the bladder to change the routine follow-up cystoscopies

      Introduction and Objectives

      Frequency of cystoscopic follow-up of superficial bladder cancer is still causes confusion and has not been clearly defined. Cystoscopic follow-up is a considerable workload for the urologist and is also an invasive procedure for the patient with high costs. In the study, we reviewed our experience to determine any possible criteria which can lead to reduce the frequency of follow-up cystoscopy, retrospectively.

      Material and Methods

      Between 1998–2008, 641 patients with primary stage Ta and T1 bladder cancers that were treated in our department were evaluated retrospectively. The pattern of recurrence and the recurrence rates in the first year were assessed.

      Results

      The recurrence rate was 21% at 3 months. The recurrence rates at 6 and 9 months were 9.2 and 11.9% respectively. The recurrence rate at 12 months was 8.3%. For tumors with no recurrence at 3 months, the recurrence rates at 6, 9 and 12 months were 8.6, 11.4 and 7.19% respectively. With respect to stages, there was a statistically significant difference in recurrence rate stages pTa and pT1 in the first and in the third control (p = 0.001, p = 0.003) respectively. According to the recurrence rate within the first year, the difference between G1 and G2 tumors was not statistically significant regardless of the stage (p > 0.05).

      Conclusions

      Patients with initial stage Ta or T1 grade 1 and 2 bladder cancers and negative first cystoscopy have a significantly lower recurrence rate than those with recurrence at first cystoscopy. In patients with initial low grade carcinoma, it seems logical to change the routine follow-up cystoscopy protocol. If the thirdmonth cystoscopy is tumor-free, it is appropriate to perform the next follow-up cystoscopy 1 year after the initial resection.