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Erschienen in: World Journal of Urology 2/2020

27.04.2019 | Original Article

Clinical significance of urothelial carcinoma ambiguous for muscularis propria invasion on initial transurethral resection of bladder tumor

verfasst von: Oudai Hassan, Belkiss Murati Amador, Kara A. Lombardo, Daniela Salles, Fatima Cuello, Alexander S. Marwaha, Marcus J. Daniels, Max Kates, Trinity J. Bivalacqua, Andres Matoso

Erschienen in: World Journal of Urology | Ausgabe 2/2020

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Abstract

Purpose

To evaluate the clinical significance of invasive urothelial carcinoma that is ambiguous for muscularis propria invasion on initial transurethral resection of bladder tumor (TURBT).

Methods

All consecutive in-house TURBTs with invasive urothelial carcinoma from 1999 to 2017 that underwent radical cystectomy (RC) were grouped as follows: invasion of the lamina propria (INLP; n = 102; 24%), invasion of muscularis propria (INMP; n = 296; 69%) and ambiguous for muscularis propria invasion (AMP; n = 30; 7%). AMP was defined as extensive invasive carcinoma displaying thin muscle bundles where it is difficult to determine with certainty if those muscle bundles represent muscularis mucosae or muscularis propria (detrusor). Cases with any amount of small cell carcinoma or prior therapy were excluded.

Results

The average age was 66 years in INLP, 67 years in INMP, and 65 years in AMP. RC showed invasive carcinoma stage pT2 or above in 50/102 (49%) of INLP vs. 255/296 (86%) of INMP (P ≤ 001) vs. 25/30 (83.33%) of AMP (P = 0.002). Lymph nodes showed metastatic carcinoma in 18/98 (18.36%) of INLP vs. 96/272 (35.29%) of INMP (P = 0.002), and 6/25 (24%) in AMP (P = 0.729). The average follow-up was 48 months (range 0–192). Survival of AMP patients was similar to INLP and both were significantly better than INMP (P = 0.002 and P = 0.016).

Conclusion

The great majority of patients with AMP on initial TURBT have advanced disease on RC and emphasizes the need for early repeat TURBT or even consideration of early cystectomy to lower the risk of worse pathological findings and to prolong survival.
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Metadaten
Titel
Clinical significance of urothelial carcinoma ambiguous for muscularis propria invasion on initial transurethral resection of bladder tumor
verfasst von
Oudai Hassan
Belkiss Murati Amador
Kara A. Lombardo
Daniela Salles
Fatima Cuello
Alexander S. Marwaha
Marcus J. Daniels
Max Kates
Trinity J. Bivalacqua
Andres Matoso
Publikationsdatum
27.04.2019
Verlag
Springer Berlin Heidelberg
Erschienen in
World Journal of Urology / Ausgabe 2/2020
Print ISSN: 0724-4983
Elektronische ISSN: 1433-8726
DOI
https://doi.org/10.1007/s00345-019-02782-y

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