Clinicopathological analysis of recurrence and progression of low-grade papillary urothelial carcinoma of the urinary bladder: Predicting the outcome |
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| Institution: | 1. Arkadi M. Rywlin M.D. Department of Pathology and Laboratory Medicine, Mount Sinai Medical Center, Miami Beach, FL 33140, USA;2. Department of Translational Medicine, Herbert Wertheim College of Medicine, Florida International University, Miami, FL 33199, USA;3. Department of Mathematics, Faculty of Sciences, Lebanese University, Nabatieh, Lebanon;4. Division of Urology, Columbia University, Mount Sinai Medical Center, Miami Beach, FL 33140, USA;5. Herbert Wertheim College of Medicine, Florida International University, Miami, FL 33199, USA;1. Department of Diagnostic Pathology, Shizuoka Cancer Center, Shizuoka, Japan;2. Department of Hepatobiliary-Pancreatic Surgery, Shizuoka Cancer Center, Shizuoka, Japan;3. Department of Diagnostic Pathology, Fukui Prefecture Saiseikai Hospital, Fukui, Japan;4. Department of Surgery, School of Medicine, Nihon University, Tokyo, Japan;5. Department of Internal Medicine, Fukui Prefecture Saiseikai Hospital, Fukui, Japan;6. Department of Digestive Surgery, Fukui Prefecture Saiseikai Hospital, Fukui, Japan;7. Department of Human Pathology, Juntendo University School of Medicine, Tokyo, Japan;8. Department of Digestive Internal Medicine, Shizuoka Medical Center, Shizuoka, Japan;9. Department of Human Pathology, Kanazawa University School of Medicine, Kanazawa, Japan;1. Department of Pathology, Beijing Tongren Hospital, Capital Medical University, Beijing Key Laboratory of Head and Neck Molecular Diagnostic Pathology, Beijing 100730, China;2. Department of Pathology, Beijing Chuiyangliu Hospital, Beijing 100022, China;1. Department of Pathology, Medical College of Wisconsin, Milwaukee, WI, USA;2. Otolaryngology-Head and Neck Surgery, Medical College of Wisconsin, Milwaukee, WI, USA;3. Institute of Medical and Public Health Research, Ilia State University, Tbilisi, Georgia;1. Department of General Surgery, Shengjing Hospital of China Medical University, Shenyang, China;2. Department of Pathology, Shengjing Hospital of China Medical University, Shenyang, China;3. Medical Research Center, Shengjing Hospital of China Medical University, Shenyang, China |
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| Abstract: | BackgroundUrothelial carcinoma of the urinary bladder is the most common malignancy of the urinary system. Patients with low grade papillary urothelial carcinoma (LGPUC) usually have a low risk for tumor recurrence and progression; yet a subset of patients develop recurrence or grade/stage progression to high-grade papillary urothelial carcinoma (HGPUC). The clinicopathological and molecular factors that contribute to this progression are yet to be determined.ObjectivesIn our study, we aimed to assess the incidence and clinicopathological factors associated with tumor recurrence/progression of LGPUC.MethodsUsing a pathological database of surgical specimens from patients who underwent bladder biopsies and/or transurethral resection of bladder tumors (TURBTs) between August 01, 2011, and July 31, 2021, at a large academic medical center, a single-center retrospective cohort analysis was performed, and medical charts of patients were reviewed.ResultsOf the total 258 patients included, 157 (60.9 %) had “no recurrence”, 85 (32.9 %) had ≥1 “recurrence of LGPUC”, and 16 (6.2 %) had “grade progression to HGPUC”. The mean follow-up time was 31.5 ± 32 months. Patients with “grade progression” and “recurrence of LGPUC” had larger mean tumor size on initial biopsy and multiple lesions on initial cystoscopy compared to those with “no recurrence.” Interestingly, former smokers had 2.5- and 8.5-times higher risk of recurrence of LGPUC and grade progression, respectively.ConclusionSince the majority of our patients did not develop recurrence, we question whether there is tendency to overclassify the papillomas as LGPUC based on the 2004 WHO/ISUP consensus grading classification. |
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