Assessment of transurethral resection of the bladder specimens with pT1 high-grade urothelial carcinoma for the predictor features of muscularis propria invasion on radical cystectomy specimens

2018 ◽  
Vol 37 ◽  
pp. 25-29
Author(s):  
Gozde (Gözde) Kir ◽  
Rabia Burcin (Burçin) Girgin ◽  
Tuce (Tuçe) Soylemez (Söylemez) ◽  
Mukaddes Kubra (Kübra) Melemez ◽  
Cumhur Selcuk (Selçuk) Topal ◽  
...  
Keyword(s):  
Urothelial Carcinoma ◽  
Radical Cystectomy ◽  
Transurethral Resection ◽  
Muscularis Propria ◽  
High Grade

scholarly journals Carcinosarcoma of the bladder: case report and review of the literature

2013 ◽  
Vol 5 (4) ◽  
pp. 69
Author(s):  
Arda Akoluk ◽  
Yagil Barazani ◽  
Denisa Slova ◽  
Sovrin Shah ◽  
Basir Tareen
Keyword(s):  
Case Report ◽  
Radical Cystectomy ◽  
Transurethral Resection ◽  
Bladder Tumour ◽  
Muscularis Propria ◽  
Complete Resection ◽  
High Grade ◽  
Review Of The Literature ◽  
Almost All ◽  
Disease Free

Primary osteosarcomas of the bladder account for about 0.04% ofbladder neoplasms. Most of the patients in the literature expiredwithin 6 months and, in almost all of the cases in the literature,radical cystectomy with postoperative chemotherapy was thetreatment choice. A 79-year-old gentleman presented with grosshematuria. Cystoscopy demonstrated a 2- to 3-cm tumour along thelateral wall of the bladder. The tumour was resected incompletelyvia initial transurethral resection of bladder tumour (TURBT), anda second TURBT was subsequently performed to fully resect theresidual mass. Surgical pathology from these 2 resections revealedosteosarcoma with invasion into the muscularis propria. Acystoprostatectomy was performed and final pathologic specimenrevealed high-grade CIS without evidence of residual osteosarcoma.Postoperatively, the patient did not receive chemotherapy orradiation and currently remains disease-free 2 years post-radicalcystectomy. Only 33 well-documented cases of primary osteosarcomaof the bladder have been reported to date. However, thereare only 3 cases in which TURBT resulted in complete resection.

scholarly journals Metastatic Small Cell Carcinoma of the Urinary Bladder That Recurred in the Vagina 6 Years after Radical Cystectomy: A Case Report

2018 ◽  
Vol 2018 ◽  
pp. 1-5 ◽  
Author(s):  
Makoto Isono ◽  
Keiichi Ito ◽  
Shinsuke Hamada ◽  
Masahiro Takahashi ◽  
Hidenori Sasa ◽  
...  
Keyword(s):  
Urinary Bladder ◽  
Urothelial Carcinoma ◽  
Cell Carcinoma ◽  
Radical Cystectomy ◽  
Small Cell Carcinoma ◽  
Transurethral Resection ◽  
Small Cell ◽  
Pelvic Bone ◽  
High Grade ◽  
Surgical Specimen

Small cell carcinoma (SCC) of the urinary bladder is highly aggressive and portends a poor outcome. Herein, we report a patient with recurrent SCC of the urinary bladder who experienced an unusually long-term disease-free duration after radical cystectomy. The patient was a 60-year-old woman who had undergone transurethral resection followed by radical cystectomy for muscle-invasive bladder cancer (high-grade urothelial carcinoma with adenocarcinomatous differentiation) 6 years prior; the surgical specimen had a negative surgical margin. She was referred to our hospital because of continuous bleeding from her vagina. Magnetic resonance imaging showed a mass located at the anterior wall of her residual vagina, a biopsy of which confirmed a pathological diagnosis of adenocarcinoma. The vaginal tumor and a section of the sigmoid colon were resected en bloc and were pathologically diagnosed as adenocarcinoma and SCC. We reevaluated the initial transurethral resection specimen and found SCC with foci of adenocarcinoma concomitant with high-grade urothelial carcinoma. Local recurrence and metastasis at the pelvic bone occurred 4 months later; although radiation therapy was performed, she died of the progressive disease.

scholarly journals Recurrence and upstaging rates of T1 high-grade urothelial carcinoma of the bladder on repeat resection in a Canadian, resource-limited, healthcare system

2018 ◽  
Vol 12 (8) ◽  
Author(s):  
Adam Kinnaird ◽  
Peter Dromparis ◽  
Howard Evans
Keyword(s):  
Urothelial Carcinoma ◽  
Healthcare System ◽  
Bladder Tumour ◽  
Muscularis Propria ◽  
High Grade ◽  
Recurrence Rates ◽  
Repeat Resection ◽  
Resource Limited ◽  
Carcinoma Of The Bladder ◽  
Muscle Invasive

Introduction: Non-muscle-invasive bladder cancer is the most expensive malignancy to treat. Current Canadian guidelines recommend repeat transurethral resection of bladder tumour (TURBT) within six weeks after initial resection of T1 high-grade (T1HG) urothelial carcinoma, prior to initiation of intravesical bacillus Calmette- Guerin treatment. This is a burden on operating room usage and adds further cost and risk of complications. Internationally, major cancer centres report significant rates of recurrence and upstaging on repeat resection, however, minimal Canadian data is available. We aimed to determine the rate of recurrence and upstaging in a resource-limited, Canadian healthcare system.Methods: A retrospective review of patients receiving TURBT between November 2009 and November 2014 was performed. Patients were included if they had all three of the following: a pathological diagnosis of T1HG, adequate muscularis propria present in the specimen, and a repeat resection.Results: We reviewed 3166 patients who underwent TURBT and found 173 to meet our inclusion criteria. The overall recurrence and upstaging rates were 57.2% and 9.2%, respectively. Tumour recurrence and upstaging occurred more often in patients who had repeat resection after 12‒24 weeks compared to those patients whose repeat resection occurred within 12 weeks.Conclusions: Although recurrence rates are similar, we have found upstaging rates to be three- to four-fold lower than those previously reported. Despite this, one in 10 patients will be upstaged, justifying use of this resource within our healthcare system. Finally, timely repeat resection, within 12 weeks appears to be associated with preventing disease progression.

scholarly journals Complications of radical cystectomy for bladder cancer

2018 ◽  
Vol 6 (12) ◽  
pp. 3898
Author(s):  
Maliikarjuna Gurram ◽  
Ravichander G. ◽  
Ravi Jahagidar ◽  
Vinay Reddy
Keyword(s):  
Bladder Cancer ◽  
Urothelial Carcinoma ◽  
Radical Cystectomy ◽  
Bladder Tumor ◽  
Invasive Bladder Cancer ◽  
Safe Procedure ◽  
High Grade ◽  
Early Complications ◽  
Muscle Invasive Bladder Cancer ◽  
Muscle Invasive

Background: Radical cystectomy with pelvic lymph node dissection is the standard treatment for muscle-invasive bladder cancer. With the advent of improved surgical techniques and postoperative management, the complications and mortality rates have reduced. The present study was done to analyse the perioperative, early and late compilations following radical cystectomy for bladder tumor.Methods: This is a prospective observational study of patients who underwent radical cystectomy for invasive bladder tumor from February 2016 to November 2017. Radical cystectomy was done through midline transperitoneal approach.  Urinary diversion was done by ileal conduit. All patients were followed at 6th week, 3rd month, 6th month, and at 1 year.Results: Total 21 patients underwent radical cystectomy, 17(80.95%) were males and 4 (19.04%) females. The median age was 60 years, ranging from 40 to 73 years. The   most common age group was 60 to 75 years (52.3%). Thirteen (61.9%) patients were smokers and all were males. Painless haematuria alone was most common presentation (of bladder tumor) seen in 15 (71.4%) patients. Early complications were seen in 8 (38.09%) patients, most common early complication was urinary leak 2 (9.5%) patents, other early complications were bowel leak, wound dehiscence, pelvic collection, burst abdomen, prolonged ileus, subacute intestinal obstruction, acute kidney injury and sepsis seen in one (4.25%) patient each. Late complications were seen in 4 (19.04%) patients.  Pelvic recurrence was the most common late complication seen in 2 (9.55%) patients. Ureteric stricture was seen in one patient (4.75%) for which percutaneous nephrostomy and antegrade DJ stenting was done. Among the histopathological variants of tumor 20 (95.25%) patients had high grade variants and only one (4.75%) had low grade papillary urothelial carcinoma. Among the high grade variants most common pathology was urothelial carcinoma in 17 (80.9%) patients.Conclusions: Radical cystectomy remains the main stay of treatment in muscle-invasive bladder cancer. This is relatively safe procedure with minimal morbidity and mortality.

scholarly journals Incidence of various urothelial malignancy in patients undergoing transurethral resection of bladder tumour in tertiary care hospital

2020 ◽  
Vol 8 (1) ◽  
pp. 346
Author(s):  
Kamal Preet Kaur ◽  
Gurpreet Singh Bhangu ◽  
Darpan Bansal ◽  
Divya Julka
Keyword(s):  
Urinary Bladder ◽  
Urothelial Carcinoma ◽  
Transurethral Resection ◽  
Bladder Tumor ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Care Hospital ◽  
High Grade ◽  
Urothelial Malignancy ◽  
Papillary Urothelial Carcinoma

Background: Urinary bladder lesions are a great health concern as it lies among the top ten most common cancers in the world. These range from benign, harmless lesions that do not recur to life threatening tumors. The present study was undertaken to study incidence of various urothelial cancer in patients undergoing transurethral resection of bladder tumor in tertiary care hospital, as the treatment, follow up and prognosis is highly variable with different subtypes of bladder cancer.Methods: A hospital based descriptive cross-sectional study was conducted on all patients undergoing transurethral resection of bladder tumor from December 2018 to May 2020 in the Department of General Surgery of Sri Guru Ramdas Institute of Medical Sciences and Research, Amritsar. Based on World Health Organization (WHO) classification incidence of various urothelial malignancy was calculated.Results: Out of 80 patients with growth urinary bladder, 4 patients (5% of total patient) were diagnosed as case of papilloma, 26 patients (32.5% of total patients) were diagnosed as low grade papillary urothelial carcinoma, 50 patients (62.5% of total patients) were of high grade papillary urothelial carcinoma. There were no case of PUNLMP in our study.Conclusions: It can be concluded that majority of the patient undergoing transurethral resection of bladder tumor are diagnosed with high grade papillary carcinoma. 

scholarly journals Clinical outcome and quality of life in octogenarian patients with muscle-invasive urothelial carcinoma of the bladder treated with radical cystectomy or transurethral resection of the bladder tumor: a retrospective analysis of 143 patients

2021 ◽  
Author(s):  
Christian Rehme ◽  
Beatrix Fritsch ◽  
Luca Thomas ◽  
Stefan Istin ◽  
Carolin Burchert ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Clinical Outcome ◽  
Urothelial Carcinoma ◽  
Radical Cystectomy ◽  
Transurethral Resection ◽  
Cox Regression ◽  
Wilcoxon Test ◽  
Cancer Specific Survival ◽  
Muscle Invasive

Abstract Purpose To compare clinical outcome and quality of life (QoL) in octogenarian patients with muscle-invasive urothelial carcinoma (MIBC) either treated by radical cystectomy (RC) or transurethral resection of the tumor (TURBT). Methods We identified octogenarian patients with MIBC in our institutions since 2005. Clinical treatment outcomes and QoL were analyzed. Uni- and multivariable Cox regression analyses, two-tailed Wilcoxon test, Mann–Whitney test and Fisher’s exact test were assessed as appropriate. QoL was evaluated using FACT-G (Functional Assessment of Cancer Therapy-General) questionnaire. Results 143 patients were identified (RC: 51 cases, TURBT: 92 cases). Mean follow-up was 14 months (0–100 months). Median overall survival (OS) was 12 months in the RC group and 7 months in the TURBT group. TURBT and low preoperative hemoglobin were independent risk factors for reduced cancer-specific survival (CSS) (TURBT: p = 0.019, Hb: p = 0.008) and OS (TURBT: p = 0.026, Hb: p = 0.013) in multivariable analyses. Baseline QoL was low throughout the whole cohort. There was no difference in baseline FACT-G scoring comparing RC and TURBT (FACT-G total score (median): RC 43.7/108 vs. TURBT 44.0/108, p = 0.7144). Increased FACT-G questionnaire scoring was assessed for RC patients (median percentage score change RC 22.9%, TURBT 2.3%, p < 0.0001). Conclusion RC and TURBT are feasible treatment options for MIBC in octogenarian patients. In our cohort, RC was associated with increased CSS, OS and QoL. QoL in general was low throughout the whole cohort. Interdisciplinary decision-making has to be improved for these critically ill patients.

High-grade invasive urothelial carcinoma with focal plasmacytoid differentiation successfully treated by transurethral resection followed by chemoradiotherapy

2011 ◽  
Vol 18 (12) ◽  
pp. 851-853 ◽  
Author(s):  
Takashi Kawahara ◽  
Hisashi Oshiro ◽  
Zenkichi Sekiguchi ◽  
Hiroki Ito ◽  
Kazuhide Makiyama ◽  
...  
Keyword(s):  
Urothelial Carcinoma ◽  
Transurethral Resection ◽  
High Grade

Frequent truncating mutations of the cohesin complex gene STAG2 in urothelial carcinoma of the bladder.

2014 ◽  
Vol 32 (4_suppl) ◽  
pp. 290-290
Author(s):  
David A. Solomon ◽  
Jung-Sik Kim ◽  
Jolanta Bondaruk ◽  
Shahrokh F. Shariat ◽  
Zeng-Feng Wang ◽  
...  
Keyword(s):  
Urothelial Carcinoma ◽  
Radical Cystectomy ◽  
Transurethral Resection ◽  
Disease Free Survival ◽  
Early Event ◽  
Low Grade ◽  
Cohesin Complex ◽  
Urothelial Carcinomas ◽  
Muscle Invasive ◽  
Invasive Carcinomas

290 Background: We have recently identified the cohesin complex subunit STAG2 as a gene that is somatically mutated in human cancer and whose inactivation leads directly to chromosomal instability and aneuploidy (Solomon et al, Science, 2011 Aug 19). However, the complete tumor spectrum harboring STAG2 mutations and the clinical significance of STAG2 inactivation in cancer remain undefined. Methods: Immunohistochemistry was used to screen 2,214 tumors from each of the major tumor types for somatic loss of STAG2 expression. Sequencing of the STAG2 gene was performed on 111 urothelial carcinomas, and Affymetrix CytoscanHD Arrays were performed on STAG2 mutant tumors. Clinical data from 34 patients with non-muscle invasive urothelial carcinoma treated with transurethral resection and 349 patients with invasive urothelial carcinoma treated with radical cystectomy was correlated with tumor STAG2 status. Results: Complete loss of STAG2 expression was discovered in 52/295 urothelial carcinomas (18%), ranging from low grade papillary to high grade muscle invasive tumors. DNA sequencing revealed somatic truncating mutations of STAG2 in 23/111 urothelial carcinomas of the bladder, including 9/25 papillary non-invasive carcinomas (36%), 6/22 superficially invasive carcinomas (27%), and 8/64 muscle invasive carcinomas (16%). STAG2 mutation was found to be an early event in bladder tumorigenesis, frequently associated with alterations in p53 signaling, and often correlated with numerous chromosomal copy number aberrations per tumor. STAG2 loss in non-muscle invasive urothelial carcinomas treated with transurethral resection was found to be associated with increased disease-free survival (p=0.05), while STAG2 loss in invasive urothelial carcinomas treated with radical cystectomy was found to be associated with increased lymph node metastasis (p=0.03), earlier disease recurrence (p=0.04), and reduced cancer-specific survival (p=0.04). Conclusions: These results identify STAG2 as one of the most commonly mutated genes in bladder cancer, and demonstrate that STAG2 loss defines molecular subgroups of urothelial carcinomas with distinct clinical outcomes.

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