I. Introduction:Non Invasive Bladder Cancer represent the great majority of the tumours of the bladder (70% to 80%).In fact, it relate several entities (pTis, pTa, pT1) for which the prognosis, the evolutionary risk and the treatment are different. It has two evolutionary problems: the recurrence and progression. Two questions which arise:The existence of one or more indicators which allow precociously envisaging the risks of recurrence and progression? Which treatment to propose to decrease or avoid these risks? The world literature, by multiple publications, tries to answer these two questions in order to propose diagnostic and therapeutic strategy adapted to the evolutionary risk of each tumour.
II. Objective:The objective of this work is to give a progress report on the clinicopathological data which make it possible to define among the tumours urotheliales the groups at the risk: weak risk, intermediate risk and high risk in order to rationalize their therapeutic indications and their supervision.
III. Material and method:Our work concerns the retrospective study of 51 cases of non-invasive tumours of bladder treated in the service of urology (CHU Hassan II-Fès) during a period of 3 years (2011-2014). 3 detailed medical records allowed us this study.
IV.Results:The non-invasive bladder tumours account for 68% of all the tumours of bladder.The patients were distributed in 46 men (90.2 %) and 05 women (9.8%).The average age of the men was 60.4 with some 33 years and 86 years extremes and that of the women, was 70.3 with some 46 years and 88 years extremes. The smoking notion is noted among 37 patients (72.5%), the chronic antecedent of bladder irritation is found among 2 patient (3.9%).The macroscopic haematuria was the revealing sign most frequent (48 cases so 94%).On the paraclinical level, ultrasound revealed the tumour among 48 patients so 94%).The cystoscopy revealed the tumour among all our patients.The urothelial carcinoma is the only histological type found in our series.The tumours pTa are noted among 26 patients so 50.9 %, the tumours pT1 are noted among 23 patients so 45% and the CIS is noted at 2 patients so 3.9% of the cases.On the therapeutic level:The RTU was the only treatment among 04 patients (7.8%).The total cystectomy is carried out among 05 patients (9.8 %).All the patients having a tumour at the intermediate or high risk profited from a BCG therapy at a rate of a meeting per week during 6 weeks.The supervision of the treated patients is clinical, echographic and cystoscopic. The evolution is characterized by: Recurrences: 10 patients, after a mean of 03 months.
V. Conclusion:The non-invasive bladder tumours represent a very heterogeneous group of tumours which are characterized by the difficulty in appreciating their prognosis with the initial diagnosis and thus the therapeutic indications. Among these tumours, 60% to 70% will recur and 10% to 20% will progress towards tumours which invade the muscle while becoming potentially metastatic. This unfavourable evolution of tumours originally superficial must be detected as soon as possible. Upstream, the prevention by the fight against the nicotine addiction and the factors of occupational hazard are essential