The value of histologic grading and staging, random biopsies, tumor and bladder mucosa blood group antigens, in predicting progression of superficial bladder cancer

We followed 67 patients with superficial bladder cancer (pT(A), pT₁) for 12-48 months (mean, 26.8 months) after surgical removal of their tumors. In additition to tumor grade and stage, we recorded morphologic characteristics of randomized mucosal biopsies and blood group antigens of the tumors and 'normal' bladder mucosa by means of the specific red cell adherence test. Results were correlated with tumor recurrence and tumor progression rates. The loss of blood group antigens in tumor tissue and random mucosal biopsies correlated well with progression of recurrent tumors. It is recommended that such measurements be used to decide on more aggressive surgical therapy or extensive (possibly lifelong) prophylactic instillation therapy, e.g. with mitomycin. Our own experience with mitomycin has shown that it can control tumor recurrence, tumor progression, and survival in such high-risk patients.