Factores pronósticos en la recidiva y progresión del cáncer superficial vesical. Grupos de riesgo (Parte II)

PRONOSTIC FACTORS ON RECURRENCE AND PROGRESSION OF SUPERFICIAL BLADDER CANCER. RISK GROUPS (PART II) Introduction: We try to establish risk groups combining the characteristics of each bladder tumour, for a better monito- ring of these patients. Material and Methods: Once known the variables implied in recurrence and progression we analyze the data to establish the extreme groups, so, the one with the worse and the one with the better prognostic, remaining a residual group that would correspond of the tumours of intermediate prognostic. Results: From the results obtained, we can establish three risk groups: Bad prognostic group (high risk) : High grade tumours (G3), isolated or associated Tis and multiple or recurrent grade 2 tumours that were recurred in less than 6 months; Intermediate prognostic group: multiple TaG1 tumours, as well as not multiple Ta-1G2 and T1G1 (less than 3 tumours) and Group of low risk: Single TaG1 tumours. Discussion: According to these results the group of badly risk, involves a high risk of recurrence and progression. The most effective treatment was the BCG (bacillus Calmette-Guerin) with maintenance, requiring a long-term control, more intense in the 2 first years after the RTU. In the group of intermediate risk, the rates of long-term superficial recurren- ce were as high as those of the high risk group, being needed a long-term control, in this group was effective the treat- ment with chemotherapy or BCG being preferably the maintenance. Finally in the group of good risk we don't objectify progressions being the time to the recurrence the longest one, with stabilization of the rate of recurrences after one year.