Mantica G, Tappero S, Parodi S, Piol N, Spina B, Malinaric R, Balzarini F, Borghesi M, Van Der Merwe A, Suardi N, Terrone C. Bladder cancer histological variants: which parameters could predict the concordance between transurethral resection of bladder tumor and radical cystectomy specimens?
Cent European J Urol 2021;
74:355-361. [PMID:
34729225 PMCID:
PMC8552936 DOI:
10.5173/ceju.2021.140.r1]
[Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Revised: 08/10/2021] [Accepted: 08/11/2021] [Indexed: 11/22/2022] Open
Abstract
Introduction
The concordance rate of bladder cancer (BCa) histological variants (HV) between transurethral resection of bladder tumor (TURBT) and radical cystectomy (RC) is sub-optimal and is unclear which factors may influence it. The aim of this study was to identify factors that may be correlated to a higher TURBT-RC concordance rate.
Material and methods
Consecutive patients who had undergone RC between 2000 and 2019 at a single Institution with pathological evidence of HV were included. Patients with diagnosis of HV both at RC and at the previous TURBT were enlisted in the TURBT-RC Concordance Group (CG), whereas patients with only evidence of HV at RC in the TURBT-RC Non-Concordance Group (NCG). Surgical factors evaluated were the source of energy (mono- vs bipolar), surgeon’s experience (</≥100), execution of re-TURBT, number and size of specimens at TURBT.
Results
A total of 81 patients were included, 49 (60.5%) in the CG and 32 (39.5%) in the NCG. Among the surgical factors, maximal core length (MCL) was significantly higher in the CG (12.5 vs 10 mm, p = 0.014) (Table 1). At uni- and multivariable analyses, MCL>10 mm represented an independent predictor of concordance [OR 2.95; CI (1.01–8.61); p = 0.048]. Tumor recurrence, focality and dimension, source of energy, surgeon’s experience, performance of re-TURBT and total number of specimens at TURBT did not significantly predict the concordance.
Conclusions
Longer specimens at TURBT yield a higher chance to detect HV before RC. In this light, improving the quality of bladder resection means improving the management of BCa.
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