Published online Feb 28, 2006.
https://doi.org/10.4111/kju.2006.47.2.137
Prognostic Significance of the Presence of Proper Muscle in the Resected Specimens of Primary T1G3 Bladder Cancer
Abstract
Purpose
According to the presence of proper muscle in the resected specimens from primary T1G3 bladder tumors, we compared the prognosis and investigated factors that were predictive of disease progression during the follow-up and upstaging after radical cystectomy.
Materials and Methods
We reviewed the records of 157 patients who were diagnosed with primary T1G3 bladder cancer for the assessment and comparison of disease recurrence, disease progression and patient survival. There were 101 and 56 patients with and without proper muscle in the their transurethral resection (TUR) specimens (T1G3 and T1xG3, respectively); 30 and 20 of these patients, respectively, had undergone immediate cystectomy.
Results
Among the patients who were followed up after transurethral surgery, there were no differences in the survival between the two groups. For the patients treated by immediate cystectomy, the 5-year cancer-specific survival was 100% for the T1G3 patients at a mean follow-up of 54.5 months while it was 76.6% for the T1xG3 patients at a mean follow-up of 46.0 months (p=0.042). With the absence of radiologic findings suggestive of invasive bladder cancer, 55.6% of the T1xG3 patients were upstaged after radical cystectomy, whereas only 12.0% of the T1G3 patients were upstaged (p=0.002). Between the followed-up group and the cystectomy groups, more patients in the cystectomy group had non-papillary shaped bladder tumor (75.0% vs. 38.9%, respectively, p=0.010). Similarly, the T1x-G3 patients who progressed during follow-up or who were upstaged after radical cystectomy had more non-papillary shaped tumor than the patients who were without progression or upstaging (80.1% vs. 38.5%, respectively, p=0.006).
Conclusions
For primary T1G3 bladder cancer, non-papillary shaped tumor without proper muscle in the resected specimen is a risk factor for the progression during follow-up or upstaging after radical cystectomy that should warrant consideration for repeated resection or early cystectomy.
Fig. 1
The cancer-specific survival according to the presence of proper muscle in the transurethral resection (TUR) specimen. T1G3: T1G3 bladder cancer with proper muscle in the TUR specimen; T1xG3: T1G3 bladder cancer without proper muscle in the TUR specimen. (A) Follow-up groups, (B) immediate cystectomy groups.
Table 1
Comparison of patient characteristics between the followup groups
Table 2
Upstaging after radical cystectomy according to the presence of suspicious radiology* and proper muscle in transurethral resection (TUR) specimen
Table 3
Patient characteristics of T1xG3 bladder cancer
Table 4
Comparison according to progression and upstaging in T1xG3 patients*
References
-
Jakse G, Loidl W, Seeber G, Hofstadter F. Stage T1, grade 3 transitional cell carcinoma of the bladder: an unfavorable tumor? J Urol 1987;137:39–43.
-
-
Cookson MS, Sarosdy MF. Management of stage T1 superficial bladder cancer with intravesical bacillus Calmette-Guerin therapy. J Urol 1992;148:797–801.
-
-
Herr HW. Tumour progression and survival in patients with T1G3 bladder tumours: 15-year outcome. Br J Urol 1997;80:762–765.
-
-
Stockle M, Alken P, Engelmann U, Jacobi GH, Riedmiller H, Hohenfellner R. Radical cystectomy--often too late? Eur Urol 1987;13:361–367.
-
-
McDonald JR, Thompson GJ. Carcinoma of the urinary bladder: a pathologic study with special reference to invasiveness and vascular invaion. J Urol 1948;61:435–439.
-
-
Cha KB, Chung BH, Hong SJ. Clinical manifestation of tumor-recurrence and progression after transurethral resection and BCG intravesical instillation in patients with T1G3 bladder cancer. Korean J Urol 2002;43:490–495.
-
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