Carcinoma in situ of urinary bladder: incidence, treatment and clinical outcomes during ten-year follow-up.

Bladder carcinoma in situ (CIS) is a rare, high-grade intraepithelial neoplasm with a high tendency of progression and unpredictable clinical course. The aim of this study was to evaluate the incidence, treatment and clinical outcome of patients with CIS during a 10-year period. Medical records of 1062 patients with primary bladder cancer and 847 patients with recurrent bladder cancer that underwent tumor resection at Department of Urology, Split University Hospital Center, Split, Croatia, between January 2001 and December 2010, were analyzed. Among all treated patients with primary bladder neoplasms, 51 (4.8%) had CIS. Primary CIS was diagnosed in 18 (1.7%) and concomitant CIS in 33 (3.1%) patients. In the same period, 847 patients with recurrent tumors were treated by transurethral resection (TUR), 12 (1.4%) of them with secondary CIS. Clinical course was followed-up in 15 patients with primary CIS and 21 patients with concomitant (TaT1) CIS. BCG immunotherapy was applied in 12 patients with primary and 17 patients with concomitant CIS. After median follow-up of 50 months, 9 patients with primary CIS had no sign of disease, 4 progressed, 1 had recurrence and 1 died. After median follow-up of 37 months, 13 (62%) patients with concomitant CIS had complete response, 3 progressed (14%), 1 had recurrence (4%) and 4 patients died, however, only 2 (10%) of these due to bladder cancer. Of all patients receiving BCG immunotherapy, 8 (27%) had significant side effects. The incidence and treatment of patients with CIS of urinary bladder in our institution is comparable to other recent literature reports.