Tumour progression and survival in patients with T1G3 bladder tumours: 15‐year outcome

Objective To evaluate tumour progression and survival of patients with T1G3 bladder tumours who were followed for 15 years. Patients and methods A subset of 48 patients with T1G3 bladder tumours was entered into a randomized trial of transurethral resection (TUR) or TUR plus bacille Calmette‐Guèrin (BCG) therapy and followed for a minimum of 15 years. Thirty‐nine (81%) patients received one or more courses of BCG. The endpoints of the study were stage progression (defined as muscle invasion or metastasis) and disease‐specific survival. Results Of the 48 patients, 25 (52%) progressed and 15 (31%) died from the disease; 33 patients (69%) survived, including 24 (50%) with an intact bladder. The median progression‐free survival time was 151 months. Tumour progression occurred in 35% of the patients within the first 5 years, in 16% after 5–10 years and in 12% of those followed for 10–15 years. Deaths from cancer occurred in 25% of the patients in the first 5 years and in 10% of patients at risk from 5 to 15 years. Conclusions Patients with T1G3 bladder tumours who are treated conservatively are at life‐long risk of having a muscle‐invasive tumour and dying from bladder cancer.