Comparison of microscopic (pT3a) and gross extravesical extension (pT3b) in pathological staging of bladder cancer: analysis of patient outcomes

Objective To determine the prognostic value of pT3 bladder urothelial carcinoma substaging in patients without lymphatic involvement. Patients and methods Pathologic and clinical data were reviewed on patients who underwent radical cystectomy for urothelial carcinoma between 1991 and 2010. Of the 46...

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Published in:International urology and nephrology 2013-04, Vol.45 (2), p.387-393
Main Authors: Dincel, Cetin, Kara, Cengiz, Balci, Ugur, Ozer, Kutan, Ozbir, Sait, Sefik, Ertugrul, Gorgel, Sacit Nuri, Girgin, Cengiz
Format: Article
Language:English
Subjects:
Bladder cancer
Carcinoma, Transitional Cell - pathology
Carcinoma, Transitional Cell - surgery
Cystectomy
Female
Humans
Male
Medicine
Medicine & Public Health
Middle Aged
Neoplasm Invasiveness
Neoplasm Staging
Nephrology
Prognosis
Retrospective Studies
Urinary Bladder Neoplasms - pathology
Urinary Bladder Neoplasms - surgery
Urology
Urology - Original Paper
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Summary:Objective To determine the prognostic value of pT3 bladder urothelial carcinoma substaging in patients without lymphatic involvement. Patients and methods Pathologic and clinical data were reviewed on patients who underwent radical cystectomy for urothelial carcinoma between 1991 and 2010. Of the 460 reviewed patients, 74 patients were diagnosed with pathologic T3No urothelial carcinoma of the bladder. The impact of pathologic substaging (pT3a vs. pT3b) was examined to determine the effect on overall and disease-specific survival. Results Five years disease-specific and overall survival rates were 46.9 % and 39.6 % for patients with pT3aNo tumor, whereas these ratios were 34.4 and 30.3 %, respectively, for patients with pT3bNo tumor ( p  > 0.05). Mean disease-specific survival time was 43.94 ± 6.50 months for pT3aNo, while it was 39.01 ± 7.19 months for pT3bNo ( p  = 0.539). In multivariate cox regression analysis, age ( p  = 0.459), gender ( p  = 0.710), urinary diversion type ( p  = 0.088), and pT3 substaging ( p  = 0.554) were not noticed as an independent predictive factor for survival. Conclusion Macroscopic extravesical extension (pT3b) is not associated with a worse outcome than pT3a disease in lymph node-negative cases of bladder urothelial carcinoma.
ISSN:0301-1623
1573-2584
DOI:10.1007/s11255-013-0381-7