We reviewed 177 patients with superficial bladder tumors. The prognosis for 78 patients with non-invasive grades 1 to 3 tumors was excellent regardless of treatment. In 99 patients with tumors infiltrating the lamina propria the 5 and 10-year survival rates were 71 and 64 per cent, respectively. The prognosis of patients with grades 2 and 3 tumors infiltrating the lamina propria submitted to transurethral resection or cystectomy was excellent. In contrast, the prognosis was poor among patients with signs of tumor invasion of the lymphatic vessels of the lamina propria and patients undergoing transurethral resection and supervoltage irradiation. Our study indicates that patients with grade 1 to 3 bladder tumors, which are confined to the mucosa or do not infiltrate deeper than into the lamina propria should, if possible, be managed by transurethral resection. However, if lymphatic invasion is present the patient does not seem to benefit from an operation alone. Thus, the combined treatment of supervoltage irradiation and an extensive operation may be considered in these patients.