6th ESACP Congress, Heidelberg, April 7-11, 1999

A128
DNA-PLOIDY IN SUPERFICIAL BLADDER CANCER AND CORRELATION TO EARLY RECURRENCE AND PROGRESSION
Spiethoff A 1, Koser M 2, Lippert CM 2, Bohrer MH 1

1) Patholog.Institut, 2) Urolog.Klinik des Klinikums Ludwigshafen, Germany

In primary superficial bladder cancer ploidy status was determined by image cytometry and related to the risk of early recurrence and tumor progression. 80 patients with stage pTa (n=62) and pT1 (n=18) bladder cancer were included. Total observation time was 2.5 years (minimum 18 months). DNA measurements were performed by image cytometry on imprints of transurethral tumor resection (TUR) material. DNA aneuploidy was identified by interpretation of stemline. Ploidy analysis of the primary tumors revealed 56% peridiploid, 13% peritetraploid and 31 % aneuploid DNA patterns. There were significant correlations between ploidy and the histologic grade and the pathological stage showing increased rates of non-diploidy in G2/G3 tumors compared to G1 (p<0.01) and of non-diploidy in pT1 tumors compared to pTa (p<0.005). In 44 patients local tumor recurrence was observed. Recurrence rate of the aneuploid cases was nearly 2.5 fold higher than that of the peridiploid cases (88% vs. 35,6%; p<0.005). Concerning the association between the rate of recurrence and histologic grade or pathological stage, no significant correlations became obvious (p=0.1048 and p=0.2584, respectively). In 29,5% of patients with recurrent tumors (13/44) a stage progression was found. This occurred exclusively in peritetraploid (1/6) and aneuploid (12/22) tumors (p<0.005). On the other hand, no significant relation between progression and initial histologic grade (p=0.1817) or pathological stage (p=0.6857) was found. The results of this study emphasize the prognostic potential of ploidy in superficial bladder cancer.