Utility of pT3 substaging in lymph node-negative urothelial carcinoma of the bladder: do pathologic parameters add to prognostic sub-stratification?

Please always quote using this URN: urn:nbn:de:bvb:20-opus-266535
  • Purpose The value of bladder cancer (BC) substaging into macroscopic (pT3b) and microscopic (pT3a) perivesical fat extension in lymph node (Ln)-negative patients is controversially discussed and limited evidence for prognostic relevance of additional histopathological factors in pT3 BC exists. We evaluated the prognostic value of pT3 substaging and established pathological and clinical parameters with focus on tumor invasive front (TIF) and tumor size. Methods Specimens of 52 patients treated with radical cystectomy (RC) for pT3 a/bPurpose The value of bladder cancer (BC) substaging into macroscopic (pT3b) and microscopic (pT3a) perivesical fat extension in lymph node (Ln)-negative patients is controversially discussed and limited evidence for prognostic relevance of additional histopathological factors in pT3 BC exists. We evaluated the prognostic value of pT3 substaging and established pathological and clinical parameters with focus on tumor invasive front (TIF) and tumor size. Methods Specimens of 52 patients treated with radical cystectomy (RC) for pT3 a/b muscle-invasive BC were reviewed and re-evaluated by a pathologist specialized in uropathology. Clinical variables and standard histopathologic characteristics were assessed including TIF and tumor size. Their value as prognosticators for overall survival (OS) and recurrence-free survival (RFS) was evaluated. Results Mean age of patients was 67.55 years. Tumors were staged pT3a in 28 patients (53.8%) and pT3b in 24 (46.8%). Median OS was 34.51 months. Median tumor size was 3.2 cm, median TIF was 11.0 mm. Differences in OS between pT3a and pT3b were not significant (p = 0.45). Carcinoma in situ (CIS) and lymphovascular invasion (LVI) were significantly associated with pT3b tumors. Univariate analysis could not identify pathological prognosticators like TIF or tumor size for OS and RFS (p for all > 0.05). Conclusion No significant differences in OS or RFS were observed comparing Ln-negative pT3 BC following radical cystectomy. Additional pathologic variables like TIF could not be identified as prognosticator. Relevance of pT3 BC substaging needs reevaluation in larger prospective cohorts.show moreshow less

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Metadaten
Author: Moritz Maas, Johannes Mischinger, Eva Compérat, Marcus Scharpf, Falko Fend, Timlan Todenhöfer, Arnulf Stenzl, Georgios Gakis, Steffen Rausch
URN:urn:nbn:de:bvb:20-opus-266535
Document Type:Journal article
Faculties:Medizinische Fakultät / Urologische Klinik und Poliklinik
Language:English
Parent Title (English):World Journal of Urology
ISSN:1433-8726
Year of Completion:2021
Volume:39
Issue:11
Pagenumber:4021–4027
Source:World Journal of Urology 2021, 39(11):4021–4027. DOI: 10.1007/s00345-021-03697-3
DOI:https://doi.org/10.1007/s00345-021-03697-3
Pubmed Id:http://www.ncbi.nlm.nih.gov/pubmed?term=33881556
Dewey Decimal Classification:6 Technik, Medizin, angewandte Wissenschaften / 61 Medizin und Gesundheit / 610 Medizin und Gesundheit
Tag:muscle-invasive bladder cancer; pathological staging; patient outcome; perivesical extension; tumor invasion front
Release Date:2022/09/20
Licence (German):License LogoCC BY: Creative-Commons-Lizenz: Namensnennung 4.0 International