TITLE:
Clinicopathological Analysis of Patients with Nonmuscle-Invasive Bladder Cancer Who Underwent Radical Cystectomy
AUTHORS:
Naotaka Nishiyama, Hiroshi Kitamura, Masatoshi Mutoh, Masahiro Yanase, Hiroyuki Iwaki, Tadashi Hasegawa, Taiji Tsukamoto
KEYWORDS:
Clinicopathological Examination; Nonmuscle-Invasive Bladder Cancer; Radical Cystectomy, Pathological Upstaging
JOURNAL NAME:
Surgical Science,
Vol.3 No.7,
July
19,
2012
ABSTRACT: Objectives: Surgical specimens obtained at the time of the last transurethral resection of bladder tumor (TURBT) for patients with nonmuscle-invasive bladder cancer (NMIBC) who underwent radical cystectomy were retrospectively evaluated in order to investigate the relationship between pathological variation and upstaging of NMIBC. Methods and Materials: Twenty patients (19 men, 1 woman; aged 69.4 ± 12.1 (mean ± SD) years) diagnosed with NMIBC underwent radical cystectomy during follow-up. Results: Five of the 20 patients (25%) had pathological upstaging in the radical cystectomy specimens. There was a statistical association between pathological upstaging and cancer death (p = 0.002). There were three patterns of pathological variation in the upstaged specimens: 1) in patients with BCG-resistant NMIBC, urothelial carcinoma invaded through the lamina propria; 2) urothelial carcinoma showed diffuse invasion beyond the deep lamina propria, and the cancer cells had infiltrated as single cells and formed nodules; 3) TURBT specimens showed a micropapillary variant. Conclusions: Since these pathological variations correlated with pathological upstaging, they may provide an indication for cystectomy in NMIBC patients.