Korean J Urol.  2007 Apr;48(4):390-395. 10.4111/kju.2007.48.4.390.

Predictive Factors of Advancement of the Pathologic T Stage after Radical Cystectomy in Patients with Clinical T2 Stage Bladder Transitional Cell Carcinoma

• Park SY
• Choi HY
• Lee HM

• KMID: 1997105
• DOI: http://doi.org/10.4111/kju.2007.48.4.390

Abstract

PURPOSE
We wanted to identify the predictive factors of pathologic over- staging in a homogeneous series of patients who had undergone radical cystectomy for their clinical T2 stage bladder cancer.
MATERIALS AND METHODS
We retrospectively analyzed the clinicopathological parameter of 53 patients who had undergone radical cystectomy for the management of muscle-invasive transitional cell carcinoma. Of these 53 patients, 44 were men and 9 were women. The mean age was 61.3 years. After dividing the entire cohort into 2 groups according to final pathologic stage (> or = pT3 and < or = pT2), we compared the clinicopathological parameters such as the time interval between the initial diagnosis of muscle invasion and cystectomy, the number of transurethral resection of bladder tumors (TURBTs), intravesical immunochemotherapy, the tumor grade, the p53 expression, the presence of carcinoma in situ and the gross findings of transurethral resection of bladder tumor (i.e. tumor size, multiplicity and tumor configuration) between the 2 groups.
RESULTS
The final pathologic stages were < or = pT2 in 31 patients (58.5%), pT3 in 20 patients (37.7%) and pT4 in 2 patients (3.8%). Comparison of the clinical staging with the pathological staging revealed that 22 of the 53 cases (41.5%) were clinically understaged. There were no statistically significant differences between the > or = pT3 and < or = pT2 groups regarding the number of TURBTs, intravesical immunochemotheraphy, tumor grade, the p53 expression, the presence of carcinoma in situ and the gross findings of TURBT. But patients with a time interval of > or = 2 months between the diagnosis of muscle invasion and cystectomy had a significantly higher frequency of extravesical disease.
CONCLUSIONS
These results underline the need for early treatment with cystectomy, within a 2 month period, once the diagnosis of muscle invasion has been made.

Keyword

Bladder neoplasms; Cystectomy; Time factors

MeSH Terms

Carcinoma in Situ
Carcinoma, Transitional Cell*
Cohort Studies
Cystectomy*
Diagnosis
Female
Humans
Male
Retrospective Studies
Time Factors
Urinary Bladder Neoplasms
Urinary Bladder*

Figure

• 

  Fig. 1 The distribution of the final pathologic stage after radical cystectomy in 53 patients with muscle invasive transitional cell carcinoma.

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