Carcinoma of the Urinary Bladder: Clinical staging and histologic grading in relation to survival

Abstract

In a retrospective study of 111 cases of carcinoma arising from the transitional epithelium of the urinary bladder, the clinical stages and histologic grades of the tumours were compared and were correlated with the survival rates. The cases were collected over a ten-year period (1958–1967). The clinical staging was based on the case notes, and for the histologic grading according to the cellular pattern all the slides were reviewed. A relationship was found between the histologic differentiation and the clinical stage of the tumours. In nonpalpable, superficial tumours the five-year survival rate was 50 per cent. Palpable and deeper growing tumours had a poor prognosis. Survival was related also to the histologic tumour grades, with appreciably better prognosis for the well differentiated tumours. Discrepancies in the criteria for palpatory findings make comparisons of survival rates with reports in the literature uncertain. Histologic grading of the cellular pattern as judged from small superficial biopsy specimens seems to provide a more objective basis for comparing the results of treatment in malignant bladder tumours.