Grading and staging of bladder carcinoma in transurethral resection specimens. Correlation with 105 matched cystectomy specimens.

We compared the grading and staging of transurethral resection of the bladder (TURB) and cystectomy specimens for 105 patients who underwent radical cystectomy for urothelial carcinoma between 1980 and 1984. Of 105 patients, 96% underwent cystectomy within 100 days of TURB (median interval, 10 days). Grading was performed according to the 1998 World Health Organization/International Society of Urologic Pathology grading system and staging according to the 1997 TNM classification. Histologic grade was low-grade, 13; high-grade, 92 in TURB specimens; low-grade, 17; high-grade, 88 in cystectomy specimens. Pathologic stage was Ta, 15; T1, 55; and T2, 35 in TURB specimens; Ta, 5; T1, 19; T2, 19; T3, 46; and T4, 16 in cystectomy specimens. Histologic grade at TURB was associated with pathologic stage at cystectomy (P < .001). When all advanced-stage (muscle-invasive) carcinomas (pT2 or more) were considered together, 55 patients were understaged by TURB, 4 had higher stage in TURB than in cystectomy, and 46 were the same stage as by cystectomy. Forty-three of 55 patients with stage T1 carcinoma at TURB had advanced-stage carcinoma at cystectomy, including 34 who had extravesicular extension (pT3 or more). We found pathologic understanding by TURB occurs in a significant number of patients with bladder cancer; the newly proposed grading system predicted final pathologic stage.

[1]  D. Bostwick,et al.  Predicting extravesical extension of bladder carcinoma: a novel method based on micrometer measurement of the depth of invasion in transurethral resection specimens. , 2000, Urology.

[2]  D. Bostwick,et al.  Cancer heterogeneity and its biologic implications in the grading of urothelial carcinoma , 2000, Cancer.

[3]  J. Cheville,et al.  Flat intraepithelial lesions of the urinary bladder , 2000, Cancer.

[4]  M. Droller.  Tumor size predicts the survival of patients with pathologic stage T2 bladder carcinoma: a critical evaluation of the depth of muscle invasion. , 2000, The Journal of urology.

[5]  J. Cheville,et al.  Urothelial papilloma of the bladder , 1999, Cancer.

[6]  D. Bostwick,et al.  Papillary urothelial neoplasms of low malignant potential , 1999, Cancer.

[7]  D. Bostwick,et al.  Predicting cancer progression in patients with stage T1 bladder carcinoma. , 1999, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[8]  D. Bostwick,et al.  Substaging of T1 bladder carcinoma based on the depth of invasion as measured by micrometer , 1999, Cancer.

[9]  D. Bostwick,et al.  Diagnosis and grading of bladder cancer and associated lesions. , 1999, The Urologic clinics of North America.

[10]  J. Cheville,et al.  Survival of patients with carcinoma in situ of the urinary bladder , 1999, Cancer.

[11]  J. Cheville,et al.  Natural history of urothelial dysplasia of the bladder. , 1999, The American journal of surgical pathology.

[12]  Lawrence D. True,et al.  The World Health Organization/International Society of Urological Pathology consensus classification of urothelial (transitional cell) neoplasms of the urinary bladder , 1998 .

[13]  D. Esrig,et al.  Early cystectomy for clinical stage T1 transitional cell carcinoma of the bladder. , 1997, Seminars in urologic oncology.

[14]  J. Eble,et al.  Carcinoma of the urinary bladder: a review of its diverse morphology. , 1997, Seminars in diagnostic pathology.

[15]  M. Amin,et al.  Intraepithelial lesions of the urinary bladder with a discussion of the histogenesis of urothelial neoplasia. , 1997, Seminars in diagnostic pathology.

[16]  E. Holmberg,et al.  The importance of the depth of invasion in stage T1 bladder carcinoma: a prospective cohort study. , 1997, The Journal of urology.

[17]  M. Cohen,et al.  Is microstaging of early invasive cancer of the urinary bladder possible or useful? , 1996, Modern pathology : an official journal of the United States and Canadian Academy of Pathology, Inc.

[18]  N Karssemeijer,et al.  Staging urinary bladder cancer after transurethral biopsy: value of fast dynamic contrast-enhanced MR imaging. , 1996, Radiology.

[19]  N. Arikan,et al.  Staging with computed tomography, transrectal ultrasonography and transurethral resection of bladder tumour: comparison with final pathological stage in invasive bladder carcinoma. , 1996, British journal of urology.

[20]  S. Groshen,et al.  Radical cystectomy for high risk patients with superficial bladder cancer in the era of orthotopic urinary reconstruction , 1995, Cancer.

[21]  S. Kitada,et al.  Significance of invasion to the muscularis mucosae on the progression of superficial bladder cancer. , 1994, Urology.

[22]  M. Soloway,et al.  Results of radical cystectomy for transitional cell carcinoma of the bladder and the effect of chemotherapy , 1994, Cancer.

[23]  K. Cummings,et al.  Diagnosis and staging of bladder cancer. , 1992, The Urologic clinics of North America.

[24]  P. Russo,et al.  Neoadjuvant chemotherapy in invasive bladder cancer: the evolving role of surgery. , 1990, The Journal of urology.

[25]  L. True,et al.  The usefulness of the level of the muscularis mucosae in the staging of invasive transitional cell carcinoma of the urinary bladder , 1990, Cancer.

[26]  J. Eble,et al.  Benign and low-grade papillary lesions of the urinary bladder: a review of the papilloma-papillary carcinoma controversy, and a report of five typical papillomas. , 1989, Seminars in diagnostic pathology.

[27]  P. Alken,et al.  Computerized tomography: an unreliable method for accurate staging of bladder tumors in patients who are candidates for radical cystectomy. , 1989, The Journal of urology.

[28]  F. Smith,et al.  Monitoring of bladder neoplasia by low-field magnetic resonance imaging. , 1988, The British journal of radiology.

[29]  C. Morgan,et al.  Computed tomography in the evaluation, staging, and therapy of carcinoma of the bladder and prostate. , 1981, Radiology.

[30]  D. Skinner.  Current Perspectives in the Management of High‐Grade Invasive Bladder Cancer , 1980, Cancer.

[31]  W. Whitmore,et al.  A comparative study of two preoperative radiation regimens with cystectomy for bladder cancer , 1977, Cancer.

[32]  D. Skinner,et al.  Current state of classification and staging of bladder cancer. , 1977, Cancer research.

[33]  W. Whitmore,et al.  Radical cystectomy with or without prior irradiation in the treatment of bladder cancer. , 1977, Transactions of the American Association of Genito-Urinary Surgeons.

[34]  G. Murphy,et al.  Clinical staging of bladder tumors. , 1970, The Journal of urology.

[35]  M. Droller.  Cancer heterogeneity and its biologic implications in the grading of urothelial carcinoma. , 2001, The Journal of urology.

[36]  Taylor Murray,et al.  Cancer statistics, 1999 , 1999, CA: a cancer journal for clinicians.

[37]  G. Hermann,et al.  The influence of the level of lamina propria invasion and the prevalence of p53 nuclear accumulation on survival in stage T1 transitional cell bladder cancer. , 1998, The Journal of urology.

[38]  D. Grignon,et al.  Muscularis mucosa differentiates two populations with different prognosis in stage T1 bladder cancer. , 1995, Urology.

[39]  R. Dodge,et al.  Radical cystectomy for stages Ta, Tis and T1 transitional cell carcinoma of the bladder. , 1994, The Journal of urology.

[40]  D. Bostwick.  Natural history of early bladder cancer , 1992, Journal of cellular biochemistry. Supplement.

[41]  P. Bassi,et al.  Results of contemporary radical cystectomy for invasive bladder cancer: a clinicopathological study with an emphasis on the inadequacy of the tumor, nodes and metastases classification. , 1991, The Journal of urology.

[42]  L. Kivisaari,et al.  CT in determining the depth of infiltration of bladder tumors , 1985, Urologic radiology.