The most effective therapy for patients with stage A, grade II through III transitional cell carcinoma of the bladder is cystectomy. However, as only 40% of these tumors progress, 60% of the patients will be over-treated. This paper review the ability of the red cell adherence test, karyotyping, and DNA/RNA histograms to identify the 40% of tumors that will progress. All of these tests have their limitations. However, if patients with stage A, grade II-III, AB0 negative aneuploid positive tumors were subjected to cystectomy, the extent of the over-treated group would be substantially reduced.
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