Prognosis/Surveillance bladder cancer Flashcards
What factors are associated with recurrence/progression?
Grade
Concomitant CIS (if untreated, 50% progression to MIBC by 5 years)
Stage
Multifocality (single vs. 2-7 tumors vs. > 8 tumors
Tumor size > 3 cm
Tumor presence at initial 3 month cysto
Prior recurrence (T1 or CIS has 5-7% progression per year)
Typical surveillance pattern using cystoscopy for low risk bladder cancer?
Quarterly x 1 year, then annually
Typical surveillance pattern using cystoscopy for intermediate risk bladder cancer?
Quarterly x 2 years, then semiannually x 2 years, then annually
Typical surveillance pattern using cystoscopy for high risk bladder cancer?
Quarterly x 2 years, then semiannually x 2 years, then annually
Typical surveillance pattern using cytology for low risk bladder cancer?
None (if initially negative)
Typical surveillance pattern using cytology for intermediate risk bladder cancer?
Perform with every cysto (Quarterly x 2 years, then semiannually x 2 years, then annually)
Typical surveillance pattern using cytology for high risk bladder cancer?
With every cysto
Typical surveillance pattern analyzing upper tracts in low risk bladder cancer?
None (if initially negative)
Typical surveillance pattern analyzing upper tracts in intermediate risk bladder cancer?
Biennial (once every two years, get a CT urogram)
Typical surveillance pattern analyzing upper tracts in high risk bladder cancer?
Annually
On cystoscopy surveillance, if positive, what should you do in general?
Re-risk stratify, and restart surveillance timing.
What is a low risk bladder tumor?
Low grade, solitary, primary Ta tumor
Progression rate < 5% at 5 years
What is an intermediate risk bladder tumor?
Recurrent or multifocal low grade Ta/T1
Progression rate < 10% at 5 years
What is a high risk bladder tumor?
Any high grade tumor or CIS
Progression rate 25-50% at 5 years
