Down-staging (<pT2) of urothelial cancer at cystectomy after the diagnosis of detrusor muscle invasion (pT2) at diagnostic transurethral resection (TUR): is prediction possible?
Urothelial cell carcinoma (UCC) with musculus detrusor (MD) invasion is treated by cystectomy. Subsequent pathologic evaluation of cystectomies does not reveal MD invasion (<pT2) in a subgroup of patients. Our objective was to identify features at diagnostic transurethral resection (TUR) predicting...
| Publicado en: | Virchows Archiv: European Journal of Pathology Vol. 461; no. 2; pp. 149 - 157 |
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| Autores principales: | , , , , , , , , , , , |
| Formato: | research Journal Article |
| Publicado: |
Springer Nature
Aug2012
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=104444649&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 104444649 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 09456317 O1Z jtl: Virchows Archiv: European Journal of Pathology issn: 09456317 maglogo: N pubinfo: dt: Aug2012 vid: 461 iid: 2 pid: 237 pub: Springer Nature place: New York, New York artinfo: ui: 104444649 NLM22777576 2011753826 10.1007/s00428-012-1277-0 NLM22777576 PMC3421107 104444649 ppf: 149 ppct: 8 formats: fmt: @attributes: type: P tig: atl: Down-staging (<pT2) of urothelial cancer at cystectomy after the diagnosis of detrusor muscle invasion (pT2) at diagnostic transurethral resection (TUR): is prediction possible? aug: au: Beukers W Meijer T Vissers CJ Boormans JL Zwarthoff EC van Leenders GJ Beukers, Willemien Meijer, Titia Vissers, Cornelis J Boormans, Joost L Zwarthoff, Ellen C van Leenders, Geert J L H affil: Department of Pathology, Josephine Nefkens Institute, Erasmus MC, PO Box 2040, 3000 CA, Rotterdam, The Netherlands sug: subj: Carcinoma, Transitional Cell Pathology Muscle, Smooth Pathology Neoplasm Staging Bladder Neoplasms Pathology Adult Aged Aged, 80 and Over Carcinoma, Transitional Cell Mortality Carcinoma, Transitional Cell Surgery Cystectomy Female Human Immunohistochemistry Kaplan-Meier Estimator Male Middle Age Muscle, Smooth Surgery Prognosis Bladder Neoplasms Mortality Bladder Neoplasms Surgery Adult: 19-44 years Aged: 65+ years Aged, 80 & over Middle Aged: 45-64 years Female Male ab: Urothelial cell carcinoma (UCC) with musculus detrusor (MD) invasion is treated by cystectomy. Subsequent pathologic evaluation of cystectomies does not reveal MD invasion (<pT2) in a subgroup of patients. Our objective was to identify features at diagnostic transurethral resection (TUR) predicting down-staging (<pT2) at cystectomy. Patients with pathologically confirmed MD invasion at TUR followed by cystectomy for UCC without (neo-) adjuvant therapy were included (N = 106). Slides of both TUR and cystectomy specimens were reviewed, and survival analyses were performed. In total, 27/106 (26 %) tumors were down-staged at cystectomy, of which 13 (12 %) had no residual tumor (pT0). There was no significant difference in age, gender, time interval between TUR and operation, number of slides sampled, and presence of TUR scar between down-staged (<pT2) and pT2 UCC. At review of TUR specimens (N = 52) with UCC initially diagnosed as pT2, MD invasion was not confirmed in eight cases (15 %). One case showed extensive histiocytic reaction misinterpreted as UCC; in four cases, muscularis mucosae had been considered MD, and in three cases, desmoplastic reaction mimicked MD. No histologic parameter at TUR was significantly associated with down-staging at cystectomy. Overall and disease-specific survival was not statistically different in down-staged and pT2 UCC. In conclusion, down-staging of UCC (<pT2) at cystectomy occurred in 26 %. At review of diagnostic TURs, MD invasion was not confirmed in 15 %. No clinical or pathologic parameter was predictive for down-staging at cystectomy. There was no difference in survival between down-staged and pT2-staged UCC. pubtype: Academic Journal doctype: research Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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