From 1972 through 1982, 124 patients with muscle invasive T2/T3 bladder
carcinoma without evidence of distant
metastases were treated with definitive
radiotherapy (60 Gy in 6 weeks) to the pelvis at The Norwegian
Radium Hospital. Sections from
paraffin embedded biopsies taken prior to the start of treatment were prepared for
DNA flow cytometry, and 121 histograms were considered interpretable for
DNA ploidy values. Significantly improved survival was seen in patients with the following characteristic, univariate analysis: T2
tumor, macroscopically complete removal of the
tumor prior to
radiotherapy, clinically complete response to
radiotherapy, normal serum
creatinine, absence of
hydronephrosis,
tetraploid tumor, WHO performance status 0 or 1, age below 65 years. In a multivariate analysis the following pretreatment variables turned out with prognostic power in this order: normal serum
creatinine, T2
tumor,
tetraploidy, and absence of small vessel invasion. When including response to
therapy, the following factors were significantly predictive of a beneficial survival: clinically complete response after
radiotherapy, normal
creatinine, T2
tumor and
tetraploidy.
Tetraploidy was associated with response to
radiotherapy when compared to diploid
tumors (p = 0.07). This relationship alone did not explain the better survival of patients with
tetraploid tumors, and other factors concerned with "
tumor aggressivity" may be additional explanatory parameters.
DNA ploidy values provide valuable information in the pretreatment situation concerning the prognosis for patients with T2/T3 bladder
carcinoma.