The impact of tumor invasion to muscularis mucosaevascular plexus on patient outcome in pT1 bladder urothelial carcinoma

  • Ahmet Sahan Kartal Dr. Lutfi Kirdar Training and Research Hospital, Department of Urology, Istanbul, Turkey.
  • Fatma Gerin Marmara University, Department of Pathology, Istanbul, Turkey.
  • Asgar Garayev Marmara University, Department of Urology, Istanbul, Turkey.
  • Emine Bozkurtlar Marmara University, Department of Pathology, Istanbul, Turkey.
  • Alkan Çubuk | alkancubuk@hotmail.com Kartal Dr. Lutfi Kirdar Training and Research Hospital, Department of Urology, Istanbul, Turkey.
  • Orkunt Ozkaptan Kartal Dr. Lutfi Kirdar Training and Research Hospital, Department of Urology, Istanbul, Turkey.
  • Kasım Ertas Yuzuncu Yıl University, Department of Urology, Van, Turkey.
  • Yıloren Tanıdır Marmara University, Department of Urology, Istanbul, Turkey.
  • Haydar Kamil Cam Marmara University, Department of Urology, Istanbul, Turkey.
  • Ilker Tınay Marmara University, Department of Urology, Istanbul, Turkey.

Abstract

Objectives: T1 bladder cancer has a wide range of tumor behavior and lamina propria invasion depth has a high potential risk of disease progression. To evaluate the patient outcome according to the tumor invasion to the muscularis mucosae-vascular plexus (MM-VP) in pT1 bladder urothelial carcinoma (BUC).
Materials and methods: This study is a retrospective analysis of patients consecutively recorded from 2007 to 2013. A total of 93 patients with a history of primary pT1 BUC and complete follow-up were included. We used a pathological substaging system according to the tumor invasion regarding the MM-VP: pT1a (invasion above MM-VP) and pT1b (MM-VP invasion). We evaluated recurrence-free survival (RFS), progression- free survival (PFS), disease-specific-survival (DSS) based on this sub-staging system.
Results: Pathological evaluation regarding the MM-VP invasion revealed 53 patients (57%) as pT1a BUC and 40 patients (43%) as pT1b BUC. The mean follow-up was 78.8 months. During the follow-up period; 60 patients (64.5%) had tumor recurrences, 32 patients (34.4%) had progression to invasive disease, 18 patients (19.4 %) died during follow-up related to the BUC. In 29 (54.7%) of pT1a and in 31(77.5%) of pT1b tumors, the recurrent disease was recorded during the followup period (p = 0.023). DSS rates at 5 years for pT1a and pT1b were 80.2% and 60.8%, respectively. PFS, RFS, and DSS rates were similar for pT1a/pT1b and did not reach statistical significance (p > 0.05).
Conclusions: Sub-staging of pT1 BUC according to the MM-VP invasion showed a limited impact on the outcome in our patient cohort. However, the presence of pT1b disease caused a significantly higher rate of recurrence.

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References

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Published
2020-10-02
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Online Only - Original Papers
Keywords:
T1 bladder cancer; Survival; Sub staging; Muscularis mucosae; Lamina propria depth
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How to Cite
Sahan, A., Gerin, F., Garayev, A., Bozkurtlar, E., Çubuk, A., Ozkaptan, O., Ertas, K., Tanıdır, Y., Cam, H. K., & Tınay, I. (2020). The impact of tumor invasion to muscularis mucosaevascular plexus on patient outcome in pT1 bladder urothelial carcinoma. Archivio Italiano Di Urologia E Andrologia, 92(3). https://doi.org/10.4081/aiua.2020.3.239