Tumor Behavior in Transitional Cell Carcinoma of the Bladder in Relation to Chromosomal Markers and Histopathology

Tumor cells from direct harvests and short term cultures were kary-otyped from 15 patients with transitional cell carcinoma of the bladder. There were two tumors with an apparently normal diploid karyotype, eight with counts up to 50 and with marker chromosomes, and five with counts of 60 or more and with markers. The median duration between recurrences was 3 months for the near-diploid, and 3 months for the near-polyploid tumors. One patient whose tumor was normal diploid had a recurrence at 5 months and the second patient whose tumor had normal diploid tumor had no recurrence over 15 months. Four tumors (27% of the series) had a rearrangement involving band 3p14:three had +der(5)t(3;5Xpl4;pl4) and one had +der(6)t(l;3;6Xq21;pl4;p23). Duplication 3p14 →4 3pter was observed in four tumors, and deletion 11p15 →11pter in five. Three other abnormalities were observed in three cases each:deletion 5p14 → 5pter, duplication lq23 → lq32 and deletion 6q21 →6qter. Trisomy 7 was observed as a sole clonal abnormality in one carcinoma in situ. Thirteen of 15 patients had recurrence of their tumor. Tumor progression (either in stage or grade) was evident in seven recurrent tumors. Among the seven with tumor progression, three had lip deletion, two had lip deletion plus 3p duplication, one had 3p duplication, and one had trisomy 7. Four of the five that had lip deletion underwent cystectomy and three have died. Three of eight near-diploid tumors progressed and four of five near-tetraploid tumors progressed. It will be important to characterize any cytogenetic changes that are of prognostic value, since the categorization of bladder tumors by other methods has been problematic.