The Influence of Inverted Growth Pattern on Recurrence for Patients with Non-Invasive Low Grade Papillary Urothelial Carcinoma of Bladder
The Influence of Inverted Growth Pattern on Recurrence for Patients with Non-Invasive Low Grade Papillary Urothelial Carcinoma of Bladder
Aims: To evaluate the impact of a histologically inverted pattern on recurrence in patients with newly diagnosed non-invasive, low-grade papillary urothelial carcinoma of the urinary bladder. Methods: A total of 81 patients with primary bladder non-invasive, low-grade papillary urothelial carcinoma diagnosed in a single tertiary-care centre who had at least 1-year follow-up after an initial resection were included. All slides from each case were reviewed to determine the growth pattern (exophytic versus endophytic, i.e. inverted) and other histological parameters. Clinical data were retrieved from hospital records. Results: Disease recurrence occurred in 41 (50.6%) patients. Cases with an inverted pattern showed a lower recurrence rate than those with pure exophytic tumours (37.5% versus 52.1%), a longer time to first recurrence (mean 34 versus 21.5 months) and fewer recurrence episodes (p=0.482, 0.564 and 0.051, respectively). All recurring inverted cases recurred only once during follow-up. No tumour with >80% inverted architecture recurred. Conclusion: Our results suggest that non-invasive, low-grade papillary urothelial carcinoma of the bladder tends to have a better outcome in terms of disease recurrence if it shows an inverted growth pattern. To indicate the presence and percentage of the inverted pattern in low-grade urothelial carcinomas in the pathology report might be considered as an adjunct to help long-term patient management.
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- 1. Colombel M, Soloway M, Akaza H, Böhle A, Palou J, Buckley R, et al. Epidemiology, Staging, Grading, and Risk Stratification of Bladder Cancer. European Urology Supplements 2008;7:618-26.
- 2. Allard P, Bernard P, Fradet Y, Têtu B. The early clinical course of primary Ta and T1 bladder cancer: a proposed prognostic index. Br J Urol 1998;81:692-8.
- 3. Kurth KH, Denis L, Bouffioux C, Sylvester R, Debruyne FM, PavoneMacaluso M, et al. Factors affecting recurrence and progression in superficial bladder tumours. Eur J Cancer 1995;31:1840-6.
- 4. Sylvester RJ, van der Meijden AP, Oosterlinck W, Witjes JA, Bouffioux C, Denis L, et al. Predicting recurrence and progression in individual patients with stage Ta T1 bladder cancer using EORTC risk tables: a combined analysis of 2596 patients from seven EORTC trials. Eur Urol 2006;49:466- 77.
- 5. Ulbright T, Amin M, Balzer B, Berney D, Epstein J, Guo C, et al. WHO Classification of of Tumours of the Urinary System and Male Genital Organs 2016.
- 6. Babjuk M, Böhle A, Burger M, Capoun O, Cohen D, Compérat EM, et al. EAU Guidelines on Non-Muscle-invasive Urothelial Carcinoma of the Bladder: Update 2016. Eur Uro 2017;71:447-61.
- 7. Donat SM, North A, Dalbagni G, Herr HW. Efficacy of office fulguration for recurrent low grade papillary bladder tumors less than 0.5 cm. J Urol 2004;171:636-9.
- 8. Leblanc B, Duclos AJ, Bénard F, Côté J, Valiquette L, Paquin JM, et al. Long-term followup of initial Ta grade 1 transitional cell carcinoma of the bladder. J Urol 1999;162:1946-50.
- 9. Sengupta S, Blute ML. The management of superficial transitional cell carcinoma of the bladder. Urology 2006;67(3 Suppl 1):48-54.
- 10. Hall MC, Womack S, Sagalowsky AI, Carmody T, Erickstad MD, Roehrborn CG. Prognostic factors, recurrence, and survival in transitional cell carcinoma of the upper urinary tract: a 30-year experience in 252 patients. Urology 1998;52:594-601.
- 11. Heney NM, Ahmed S, Flanagan MJ, Frable W, Corder MP, Hafermann MD, et al. Superficial bladder cancer: progression and recurrence. J Urol 1983;130:1083-6.
- 12. Jancke G, Rosell J, Jahnson S. Impact of tumour size on recurrence and progression in Ta/T1 carcinoma of the urinary bladder. Scand J Urol Nephrol 2011;45:388-92.
- 13. Sakai I, Miyake H, Harada K, Hara I, Inoue TA, Fujisawa M. Analysis of factors predicting intravesical recurrence of superficial transitional cell carcinoma of the bladder without concomitant carcinoma in situ. Int J Urol 2006;13:1389-92.
- 14. Maxwell JP, Wang C, Wiebe N, Yilmaz A, Trpkov K. Long-term outcome of primary Papillary Urothelial Neoplasm of Low Malignant Potential (PUNLMP) including PUNLMP with inverted growth. Diagn Pathol 2015;10:3.
- ISSN: 2146-3123
- Başlangıç: 2015
- Yayıncı: Erkan Mor