Substaging by estimating the size of invasive tumour can improve risk stratification in pT1 urothelial bladder cancer-evaluation of a large hospital-based single-centre series

Bertz, Simone and Denzinger, Stefan and Otto, Wolfgang and Wieland, Wolf F. and Stoehr, Robert and Hofstaedter, Ferdinand and Hartmann, Arndt (2011) Substaging by estimating the size of invasive tumour can improve risk stratification in pT1 urothelial bladder cancer-evaluation of a large hospital-based single-centre series. HISTOPATHOLOGY, 59 (4). pp. 722-732. ISSN 0309-0167,

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Abstract

Aims: The outcome of patients with pT1 bladder cancer cannot yet be reliably estimated. The aim of this study was to evaluate several parameters in one of the largest series of initial pT1 bladder cancers. Methods and results: Specimens of 309 patients with pT1 urothelial carcinoma were re-evaluated histologically, including size of infiltrating tumour area estimated as equal to or smaller than one high-power field (HPF) or larger than one HPF, and tumour infiltration in relation to the muscularis mucosae (pT1a/b). Results were correlated with clinical follow-up. Substaging by HPF was associated with tumour recurrence, progression and survival in univariate analysis, and with recurrence and progression in multivariate analysis. According to the World Health Organization (WHO) 1973 grading, 220 tumours were G3, 89 were G2, and none was G1. Tumour grading was an independent prognostic marker of survival. Substaging by HPF revealed G2 and G3 tumours as distinct prognostic groups with regard to recurrence and progression. No significance was found for substaging pT1a/pT1b. An infiltrative growth pattern was significantly correlated with progression and survival in univariate analysis. Conclusions: Comparison of two systems of substaging pT1 bladder cancer shows that measurement of the size of infiltrating tumour area by HPFs may improve risk stratification. An infiltrative growth pattern on the invasion front should be documented in the pathological report, indicating a worse outcome. Additional studies are needed to find further parameters detecting high-risk tumours.

Item Type: Article
Uncontrolled Keywords: LAMINA PROPRIA INVASION; URINARY-BLADDER; MUSCULARIS MUCOSAE; COLORECTAL-CANCER; EARLY CYSTECTOMY; CELL-CARCINOMA; SURVIVAL; STAGE; PROGRESSION; FEASIBILITY; bladder cancer; growth pattern; non-muscle-invasive; risk stratification
Subjects: 600 Technology > 610 Medical sciences Medicine
Divisions: Medicine > Lehrstuhl für Pathologie
Medicine > Lehrstuhl für Urologie
Depositing User: Dr. Gernot Deinzer
Date Deposited: 28 May 2020 07:02
Last Modified: 28 May 2020 07:02
URI: https://pred.uni-regensburg.de/id/eprint/20019

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