Dr. Yair Lotan, professor of urology at the University of Texas Southwestern Medical Center, said patients with muscle-invasive bladder cancer typically are treated by removing all or part of the bladder -- a cystectomy procedure -- but are infrequently given additional chemotherapy, despite an overall relapse rate of 1-in-3 cases.
Using five commercially available markers and the tissues of patients who had their bladders removed, the researchers tracked a group of 216 patients.
When controlled for pathologic factors such as stage, grade, lymphovascular invasion, lymph node status, surgical margin status and whether the patients had already received chemotherapy, the number of altered biomarkers were an independent predictor of cancer recurrence, the researchers found.
"It is well known that bladder cancer tumors have certain molecular alterations, but the problem is that there has been little data regarding which patients should get additional therapy, especially if there is no radiologic or pathologic evidence that the cancer has spread beyond the bladder," Lotan, the study's first author, said in a statement.
"This situation exists despite the fact that approximately 35 percent of patients treated by cystectomy develop metastatic disease and many of these individuals die of their disease."
The findings were published in the journal European Urology.