Low-risk bladder cancer rarely progresses to muscle invasion but is associated with an increased risk of disease-specific mortality compared with matched populations, new findings suggest.

Kate D. Linton, MBChB, MRCS, of the University of Sheffield in the United Kingdom, and colleagues examined the risk of disease-specific mortality in 699 patients with primary, low-risk, noninvasive (G1pTa) bladder cancer who were followed for a median of 61 months.

During follow-up, the researchers found that 17 patients died of bladder cancer, including 13 of 14 who displayed progression to muscle invasion and four of 19 who exhibited grade progression to high-grade, nonmuscle invasive disease, according to a report in The Journal of Urology (2013;189:828-833). Tumor weight and low-grade dysplasia in the initial resection specimen were found to be significantly associated with disease-specific mortality. In these patients, the rate of disease-specific mortality was five times higher than in age and gender matched general populations.

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“The rate of progression to muscle invasion and disease-specific mortality in patients with low-risk bladder cancer is low but higher than in the general population,” the investigators wrote. “Current surveillance regimens failed to detect advancing disease in time to alter its natural history. While a randomized trial is necessary to robustly confirm our findings, these observations question current surveillance regimens.”