The aim of the prospective evaluation group is to plan and conduct a prospective follow-up study of newly diagnosed bladder cancer patients. A prospective design requires a long follow-up period but allows the close observation of the natural history of the disease, the occurrence in time of molecular alterations and the unbiased evaluation of the predictive value of prognostic markers.

At present the international prospective evaluation group has not planned any meeting. A first meeting of European subgroup took place in Barcelona in March 1999 and planned the extension of an ongoing international European case-control study (EPICURO study), to examine also prognostic factors. Recruitment of the cases has already been started in Spain, Italy, France and Portugal and it is expected to recruit the approximately 2000 incident bladder cancer cases by the end of the year 2000. Cases will be followed for recurrence, progression, mortality and quality of life and a variety of biomarkers, e.g. p53, p21 will be evaluated. Immunohistochemistry will be used for all cases. Sequencing will be done in a sub-sample but there is still no definitive protocol on the criteria for the selection of those cases. Paraffin blocks are collected for all cases at diagnosis and will also be collected and evaluated at subsequent follow-up periods. Clinical history at diagnosis is abstracted from records. An "urologist friendly" follow-up sheet has been designed and has started being used in some study centres (To download this Word Document, in Spanish, click here.)

It is expected that the European initiative and the draft protocol is going to be discussed during spring 1999 within the context of the International Bladder Cancer Network and the possibility of extending the study to other centres will be evaluated.

Manolis Kogevinas
23 March 1999