To evaluate the concordance and prognostic role of histologic variants of bladder urothelial carcinomain transurethral resection of bladder tumor (TURBT) and radical cystectomy (RC) specimens.METHODS Clinicopathologic information available at the time of RC and follow-up data from 4110 RCspecimens, collected between January 2000 and December 2009 at 17 tertiary referral centerswere retrospectively analyzed and evaluated for the presence or absence of uncommon variants ofbladder urothelial carcinoma. The presence or absence of uncommon variants of bladder urothelialcarcinoma was evaluated on previous TURBT specimens of patients undergoing RC. Coxregression was used to assess the impact of these parameters on cancer-specific survival, and theKaplan-Meier test for disease-free survival was plotted for survival estimate.RESULTS Of 4110 patients, 579 were found to have uncommon variants of bladder urothelial carcinoma atRC (14.1%), whereas 266 (6.4%) at TURBT. A lack of agreement about uncommon variants wasobserved between TURBT and RC specimens in the entire population (P <.001). The presenceof uncommon variants at TURBT was associated with an increased risk of pathologic upstage(hazard ratio, 3.24; confidence interval, 1.19-6.37; P <.003) and significant decrease in cancerspecificsurvival and recurrence-free survival (P <.001).CONCLUSION Although the concordance of presence of uncommon histologic variants of urothelialbladder carcinoma between TURBT and RC is low, the presence of uncommon histologicvariants of urothelial bladder carcinoma at TURBT is associated with a less favorableclinical outcome. UROLOGY -: -e-, 2014. 2014 Elsevier Inc.
|Number of pages||6|
|Publication status||Published - 2014|