Long-term outcome of bladder papillary urothelial neoplasms of low malignant potential
Y. Fujii*, S. Kawakami*, F. Koga*†, T. Nemoto† and K. Kihara*
*Urology and Reproductive Medicine, and
†Human Pathology, Tokyo Medical and Dental University Graduate School, Tokyo, Japan
Correspondence to Y. Fujii, MD, PhD, Department of Urology and Reproductive Medicine, 1-5-45, Yushima, Bunkyo-ku, Tokyo 113–8519, Japan.
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Copyright 2003 BJU INTERNATIONAL
KEYWORDS
papillary urothelial neoplasm • low malignant potential • bladder • TCC • superficial • long-term follow-up
OBJECTIVE
To evaluate the long-term outcome of bladder papillary urothelial neoplasms of low malignant potential (PUNLMP).
PATIENTS AND METHODS
Of 475 consecutive patients with newly diagnosed bladder tumours between 1976 and 1993, 330 (69%) had superficial (Ta and T1) tumours and 53 (11%) were diagnosed as having PUNLMP. Fifty patients (mean age at presentation 57.2 years, range 26–83; male-to-female ratio 6 : 1) who were followed for> 5 years or until they died, were included in the present study. All histological slides were reviewed, and fulfilled the diagnostic criteria of the 1998 World Health Organization/International Society of Urological Pathology classification system.
RESULTS
The mean (median, range) follow-up was 11.7 (10.8, 1.3–24.4) years. During the follow-up, 30 patients (60%) had local recurrences. The 2, 5 and 10-year recurrence-free rates were 66%, 51% and 36%, respectively. No patients developed high-grade or muscle-invasive (≥ T2) carcinomas, or upper urinary tract tumours, or died from the disease. At the last follow-up, 34 patients (68%) had been disease-free for> 5 years.
CONCLUSIONS
Despite a high recurrence rate, PUNLMP carries a very low malignant potential. We agree with the use of the term 'papillary urothelial neoplasms of low malignant potential' instead of 'superficial bladder carcinoma (cancer)' for these tumours.
Accepted for publication 1 May 2003
DIGITAL OBJECT IDENTIFIER (DOI)
10.1046/j.1464-410X.2003.04415.x About DOI
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