Clinical Outcomes of cT1 Micropapillary Bladder Cancer

Purpose: While many urologists recommend radical cystectomy for micropapillary bladder cancer invading the lamina propria (cT1), contradictory small reports exist on the efficacy of conservative management with intravesical bacillus Calmette-Guerin for this disease. We report our updated experience in what to our knowledge is the largest series of patients with cT1 micropapillary bladder cancer.Materials and Methods: An institutional review board approved review of our cancer database identified 283 patients with micropapillary bladder cancer, including 72 staged with cT1N0M0 disease at diagnosis and initiation of therapy. Survival analysis was performed using the Kaplan-Meier estimator and compared using the log rank test.Results: In this cohort of 72 patients 40 received primary intravesical bacillus Calmette-Guerin and 26 underwent up-front radical cystectomy. Of patients who received bacillus Calmette-Guerin 75%, 45% and 35% experienced disease recurrence, progression and lymph node metastasis, respec...