Bladder Cancer

Abstract

Transitional cell carcinoma of the bladder is the second most common malignancy of the genitourinary tract, and the second most common cause of death among all genitourinary tumors, the 11th most common cancer on a worldwide basis, accounting for 3–4% of all malignancies. Annually, about 220,000 new cases are being diagnosed; three‐fourths of these patients are men and a disproportional (two‐thirds) number of cases occur in developed countries. It's important to underline that a distinction between superficial bladder cancer (stages Ta, T1, Tis) and invasive bladder cancer (stages T2–T4) must be taken into account due to the different prognosis and treatment approaches. As a matter of fact, bladder cancer is a heterogeneous disease with considerable variations of its natural history with 5‐year survival rates ranging from 97% to 98% of a single, well‐differentiated, and small papillary tumor to less than 10% of an invasive bladder cancer extending throughout the bladder wall with distant metastases. Among superficial bladder cancer, tumor recurrence after initial therapy varies from 30% in patients with a solitary papillary tumor to more than 90% in patients with multiple tumors. Intense research efforts are being made to identify and characterize the different types of bladder cancer and their variable biological potential. The desire to predict which superficial bladder cancer will recur or progress to invasive cancer, and which invasive bladder cancer will metastatize has spurred the development of a variety of potential prognostic factors. In this chapter we provide a contemporary review of such prognostic factors with a particular emphasis to the reliable or potential use in the clinical practice.