Carcinoma-in-situ bladder -an early indication for cystectomy?

Carcinoma in situ bladder is a high grade and ag-gressive manifestation of transitional cell carcinoma of bladder that has highly variable course. The purpose of this study is to analyse how this serious disease is dealt with, most effective treatment option available and its clinical progression inspite of intervention. All patients diagnosed to have CIS bladder histolo-gically in Harrogate District Hospital from August 94 to August 99 were included in the study. All data con-cerning the management, treatment and subsequent fol-low-up were collected from the patients′ records and analysed in a systematic way. A total of 20 patients were included in the study. Analysis showed that there was no age or sex predilection and the age group ranged from 36 to 75. It occurs either alone or with papillary bladder tumour. It is found to be poor prognostic indi-cator for subsequent ttunour recurrence. Mitomvcin was the least effective and BCG is the most effective form of intravesical treatment. Failure on BCG therapy is an earlvpredictorforaggressive treatment i.e. Radical Cys-tectomy. Eventually 1/3 of all patients diagnosed to have CIS progressed to muscle invasive disease requiring radical treatment