What is the prognosis of invasive bladder cancer that has invaded the bladder wall without treatment?

From the Guidelines

The prognosis for untreated bladder cancer that has invaded the bladder wall is generally poor, with a high risk of disease progression and reduced survival. Without treatment, this type of bladder cancer (typically stage T2 or higher) is likely to continue growing and spreading. The 5-year survival rate for patients with muscle-invasive bladder cancer who do not receive treatment is estimated to be less than 15% 1. As the cancer progresses, it can lead to:

• Further invasion of surrounding tissues and organs
• Spread to lymph nodes
• Distant metastasis to other parts of the body
• Complications such as urinary obstruction, bleeding, and pain The standard of care for muscle-invasive bladder cancer is radical cystectomy (surgical removal of the bladder) with lymph node dissection, often combined with neoadjuvant chemotherapy, as recommended by the AUA/ASCO/SUO guideline 1. This approach significantly improves survival rates compared to no treatment. It's crucial for patients diagnosed with bladder cancer that has invaded the muscle wall to seek immediate medical attention and discuss treatment options with a urologist or oncologist, considering the latest NCCN guidelines 1. Delaying or forgoing treatment will likely result in rapid disease progression and a much poorer outcome.

From the Research

Prognosis of Invasive Bladder Cancer

The prognosis of invasive bladder cancer that has invaded the bladder wall without treatment is generally poor.

• The 5-year overall survival rate for untreated patients is approximately 5% 2.
• Untreated patients have a high risk of developing metastatic disease, with 38% developing metastases within 6 months of diagnosis 2.
• The cumulative incidence of cancer-specific mortality for untreated patients is 86% at 5 years 2.

Comparison to Treated Patients

In comparison, treated patients have significantly better outcomes.

• The 5-year overall survival rate for treated patients is approximately 48% 2.
• Treated patients have a lower risk of progression to metastatic disease and cancer-specific mortality compared to untreated patients 2.

Factors Influencing Prognosis

Several factors can influence the prognosis of invasive bladder cancer, including:

• Tumor stage and grade 3
• Lymphovascular invasion and micropapillary histology 4
• Expression of specific cell surface antigens, DNA content, chromosomal aberrations, gene rearrangements, and point mutations 3
• Patient age and overall health 5, 2