scholarly journals Preoperative Clinical Predictors of Lymphovascular Invasion of Bladder Tumors at Transurethral Resection Pathology

2020 ◽  
Vol 14 (3) ◽  
pp. 135-141
Author(s):  
Kei Yoneda ◽  
Takanobu Utsumi ◽  
Ken Wakai ◽  
Ryo Oka ◽  
Takumi Endo ◽  
...  
Keyword(s):  
Bladder Cancer ◽  
Transurethral Resection ◽  
Lymphovascular Invasion ◽  
Medical Center ◽  
Preoperative Evaluation ◽  
Univariate Analysis ◽  
Urinary Cytology ◽  
High Grade ◽  
Clinical Predictors ◽  
Bladder Tumors

<b><i>Background</i></b>: The assessment of lymphovascular invasion (LVI) on the specimens of a transurethral resection of bladder tumors (TURBT) is very important for risk stratification and decision-making on further treatment for bladder cancer. <b><i>Objectives</i></b>: The present study aimed to identify clinical predictors associated with the risk of bladder cancer with LVI before a first TURBT. <b><i>Methods</i></b>: A total of 291 patients underwent a first TURBT for bladder cancer at Toho University Sakura Medical Center between January 2012 and December 2016. We analyzed predictors of LVI based on data from 217 patients and predictors of high grade and ≥ pT1 tumors based on data from the medical records of 237 patients for comparison with LVI risk factors. <b><i>Results</i></b>: Univariate analysis significantly associated LVI with episodes of gross hematuria, positive urinary cytology, and larger, non-papillary and sessile tumors. Multivariate analysis selected larger tumors [odds ratio (OR) 1.39; 95 % confidence interval (CI) 1.08-1.78; p = 0.01], and non-papillary (OR 10.05; 95% CI 3.75-26.91; p < 0.01) and sessile (OR 2.65; 95% CI 1.18-5.93; p = 0.02) tumors as significant predictors of LVI. Some predictors such as tumor size and non-papillary tumors overlapped between high-grade and ≥ pT1 bladder cancer. <b><i>Conclusions</i></b>: These predictors can help clinicians to identify patients with, or who are at high-risk for LVI before undergoing a first TURBT and to determine priorities for preoperative evaluation and scheduling consecutive treatments.

scholarly journals Impact of Lymphovascular Invasion on Prognosis in the Patients with Bladder Cancer—Comparison of Transurethral Resection and Radical Cystectomy

Diagnostics ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. 244
Author(s):  
Kei Yoneda ◽  
Naoto Kamiya ◽  
Takanobu Utsumi ◽  
Ken Wakai ◽  
Ryo Oka ◽  
...  
Keyword(s):  
Multivariate Analysis ◽  
Radical Cystectomy ◽  
Transurethral Resection ◽  
Lymphovascular Invasion ◽  
Medical Center ◽  
Univariate Analysis ◽  
The Other ◽  
Significant Prognostic Factor ◽  
Cancer Specific Survival ◽  
Positive Results

(1) Background: This study aimed to evaluate the associations of lymphovascular invasion (LVI) at first transurethral resection of bladder (TURBT) and radical cystectomy (RC) with survival outcomes, and to evaluate the concordance between LVI at first TURBT and RC. (2) Methods: We analyzed 216 patients who underwent first TURBT and 64 patients who underwent RC at Toho University Sakura Medical Center. (3) Results: LVI was identified in 22.7% of patients who underwent first TURBT, and in 32.8% of patients who underwent RC. Univariate analysis identified ≥cT3, metastasis and LVI at first TURBT as factors significantly associated with overall survival (OS) and cancer-specific survival (CSS). Multivariate analysis identified metastasis (hazard ratio (HR) 6.560, p = 0.009) and LVI at first TURBT (HR 9.205, p = 0.003) as significant predictors of CSS. On the other hand, in patients who underwent RC, ≥pT3, presence of G3 and LVI was significantly associated with OS and CSS in univariate analysis. Multivariate analysis identified inclusion of G3 as a significant predictor of OS and CSS. The concordance rate between LVI at first TURBT and RC was 48.0%. Patients with positive results for LVI at first TURBT and RC displayed poorer prognosis than other patients (p < 0.05). (4) Conclusions: We found that the combination of LVI at first TURBT and RC was likely to provide a more significant prognostic factor.

scholarly journals Impact of lymphovascular invasion in bladder cancer ~Comparison of transurethral resection and total cystectomy: a retrospective cohort study

2020 ◽  
Author(s):  
Kei Yoneda ◽  
Naoto Kamiya ◽  
Takanobu Utsumi ◽  
Ken Wakai ◽  
Ryo Oka ◽  
...  
Keyword(s):  
Multivariate Analysis ◽  
Transurethral Resection ◽  
Medical Records ◽  
Lymphovascular Invasion ◽  
Univariate Analysis ◽  
Urinary Cytology ◽  
Significant Prognostic Factor ◽  
Cancer Specific Survival ◽  
Positive Results

Abstract Background: This study aimed to evaluate the associations of lymphovascular invasion (LVI) at first transurethral resection of bladder (TURBT) and radical cystectomy (RC) with survival outcomes, and to evaluate the concordance between LVI at first TURBT and RC. Methods: We reviewed 216 patients who underwent first TURBT and 64 patients who underwent RC at our hospital. Medical records were reviewed uniformly, collecting the following data: age, sex, clinical and pathological T stage, neoadjuvant chemotherapy, grade, metastasis, urinary cytology, carcinoma in situ and LVI. Results: LVI was identified in 22.7% of patients who underwent first TURBT, and 32.8% of patients who underwent RC. Univariate analysis identified ≥cT3, metastasis and LVI at first TURBT as factors significantly associated with overall survival (OS) and cancer-specific survival (CSS). Multivariate analysis identified metastasis (hazard ratio (HR) 6.560, p=0.009) and LVI at first TURBT (HR 9.205, p=0.003) as significant predictors of CSS. On the other hand, in patients who underwent RC, ≥pT3, inclusion of G3 and LVI were significantly associated with OS and CSS in univariate analysis. Multivariate analysis identified inclusion of G3 as a significant predictor of OS and CSS. The concordance rate between LVI at first TURBT and RC was 48.0%. Patients with positive results for LVI at first TURBT and RC displayed poorer prognosis than other patients (p<0.05). Conclusions: We found that the combination of LVI at first TURBT and RC was likely to provide a more significant prognostic factor.

ROLE OF RESTAGING TRANSURETHRAL RESECTION OF BLADDER TUMOR IN PATHOLOGICAL UPSTAGING OF NON-MUSCLE INVASIVE HIGH-GRADE UROTHELIAL BLADDER TUMORS. OUR INSTITUTE EXPERIENCE

2021 ◽  
pp. 34-35
Author(s):  
Jaheer Abbas Shaik ◽  
Raghuveer Pedamallu ◽  
Ram Reddy. Ch ◽  
Rahul Devraj ◽  
Vidyasagar. S ◽  
...  
Keyword(s):  
Bladder Cancer ◽  
Transurethral Resection ◽  
Carcinoma In Situ ◽  
Residual Disease ◽  
Residual Tumour ◽  
High Grade ◽  
Bladder Tumors ◽  
Muscle Invasive

Background: Transurethral resection of supercial bladder tumours is well known to be gold standard management. It is evident from the literature that initial TURBT is not enough for accurate pathological staging in non-muscle invasive bladder cancer. Aim: Our study is aimed at role of restaging TURBT in detection of residual disease for pathological upstaging in these high-risk patients to plan appropriate treatment. Methods: This is a prospective study of 32 patients with initially diagnosed Ta/T1 high-grade bladder cancer who had restaging TURBT in a study by Department of urology, NIMS, Hyderabad between January 2016 and December 2018 were included. Low-grade tumors, carcinoma in situ and muscle invasive bladder tumors were excluded. Data elements collected on patient demographics, presence of residual disease, disease progression and recurrence in the follow-up period. The data was statistically analyzed using descriptive statistics by SPSS version 17. P value <=0.05 is considered as statistically signicant. Results: The mean age for patients included in the study was 60.5 years. In our study, we found that 15 out of 32 cases (47%) has been detected with residual disease ensuring that single TURBT may not been efcient with complete removal of tumor. Six out of 32 cases (19%) had upstaging and 5 out of 32 cases had concurrent carcinoma in situ leading to change in treatment. Therefore, 11 out of 32 cases (34%) has been under staged by initial TURBT were adequately staged by restaging TURBT and subjected to radical cystoprostatectomy or chemo radiotherapy, This mandates the need for restaging TURBT at 6-8 weeks interval for adequate staging and management. Upstaging on restaging TURBT was seen in 19%. The progression-free survival rate at 16 months was 25 % in patients with residual tumour and 94% in cases without residual disease. Conclusion: We conclude that restaging TURBT effectively detects residual disease, helping pathological upstaging and planning denitive treatment in non-muscle invasive high-grade bladder tumour.

Comparison of Thulium Laser Resection of Bladder Tumors and Conventional Transurethral Resection of Bladder Tumors for Non-Muscle-Invasive Bladder Cancer

2021 ◽  
pp. 1-6
Author(s):  
Zheng Liu ◽  
Yucong Zhang ◽  
Guoliang Sun ◽  
Wei Ouyang ◽  
Shen Wang ◽  
...  
Keyword(s):  
Bladder Cancer ◽  
Transurethral Resection ◽  
Invasive Bladder Cancer ◽  
Perioperative Outcomes ◽  
Thulium Laser ◽  
Bladder Tumors ◽  
Muscle Invasive Bladder Cancer ◽  
Laser Resection ◽  
Baseline Characteristics ◽  
Muscle Invasive

<b><i>Introduction:</i></b> The thulium laser resection of bladder tumors (TmLRBT) was increasingly used in the treatment of non-muscle-invasive bladder cancer (NMIBC) recently, and here we report the relevant outcomes of our institution to evaluate its efficacy and safety. <b><i>Methods:</i></b> We retrospectively collected the data of NMIBC patients who underwent either TmLRBT or transurethral resection of bladder tumor (TURBT). The baseline characteristics and perioperative outcomes were compared in these 2 groups. <b><i>Results:</i></b> The TmLRBT had a higher rate of detrusor identification than TURBT (97.4 vs. 87.6%, <i>p</i> = 0.001). After screening, 134 patients who underwent TmLRBT and 152 patients who received TURBT were enrolled in the analysis, and their baseline characteristics were similar. During the TURBT, 24 (15.8%) obturator nerve reflexes and 9 (5.9%) bladder perforations occurred, while none happened during the TmLRBT. After surgery, TmLRBT patients had fewer postoperative gross hematuria (38.1 vs. 96.7%, <i>p</i> &#x3c; 0.001) and postoperative irrigation (27.6 vs. 92.7%, <i>p</i> &#x3c; 0.001), and its irrigation duration was significantly shorter (2.3 vs. 3.3 day, <i>p</i> &#x3c; 0.001). During the follow-up, no significant difference in the recurrence rate was detected (<i>p</i> = 0.315). <b><i>Conclusions:</i></b> TmLRBT is a safer technique than conventional TURBT in the treatment of NMIBC, and it could offer better specimens for pathologic assessment while the cancer control was not compromised.

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