The pathologist's role in the detection of rare variants of bladder cancer and analysis of the impact on incidence and type detection

Guglielmo Mantica, Alchiede Simonato, Danelo E. Du Plessis, Massimo Maffezzini, Aldo F. De Rose, André Van Der Merwe, Carlo Terrone

Research output: Contribution to journalArticle

Abstract

BACKGROUND: Histology is one of the most important factors determining the prognosis of bladder cancers and rare variants are generally associated with decreased disease specific survival compared to pure transitional cell carcinomas. We believe that rare bladder cancer variants are likely underdiagnosed in the absence of a dedicated uro-pathologist in many centers. The objective of this study is to evaluate the contribution of a dedicated uro-pathologist on the identification of rare bladder cancer variants. METHODS: We retrospectively analyzed the clinical and histological records of all patients which underwent a radical cystectomy and lymph node dissection between January 2000 and September 2015. The sample was divided in two groups: Group A, consists of patients who underwent radical cystectomy in the absence of a dedicated uro-pathologist at our institution, whereas the Group B consists of patients who underwent surgery when a dedicated uro-pathology service was available. We then evaluated the impact of a dedicated uro-pathologist on rare variants detection. RESULTS: One hundred thirty-seven out of 551 (24.9%) of patients who underwent RC had at least one rare variant. In Group A 38/238 (16%) of patients showed a rare variant, while 99/313 (31.6%; P<0.001) in group B. Furthermore, the diagnosis of sarcomatoid variant was statistically significantly less common in group A (P=0.0026). The concordance between final radical cystectomy histology and previous transurethral resection of bladder tumor (TURBT) histology was poor in both groups (overall 50.4%). CONCLUSIONS: The presence of a dedicated urological anatomical pathologist is of paramount importance and significantly increases the detection rate of non-transitional cell carcinoma bladder cancer types, but it does not increase the concordance rate between histological diagnoses in TURBT and radical cystectomy specimens.

Original languageEnglish
Pages (from-to)594-597
Number of pages4
JournalMinerva Urologica e Nefrologica
Volume70
Issue number6
DOIs
Publication statusPublished - Dec 1 2018

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Urinary Bladder Neoplasms
Cystectomy
Incidence
Histology
Transitional Cell Carcinoma
Lymph Node Excision
Pathologists
Pathology
Carcinoma
Survival

Keywords

  • Carcinoma, transitional cell
  • Cystectomy
  • Urinary bladder neoplasms

ASJC Scopus subject areas

  • Nephrology
  • Urology

Cite this

The pathologist's role in the detection of rare variants of bladder cancer and analysis of the impact on incidence and type detection. / Mantica, Guglielmo; Simonato, Alchiede; Du Plessis, Danelo E.; Maffezzini, Massimo; De Rose, Aldo F.; Van Der Merwe, André; Terrone, Carlo.

In: Minerva Urologica e Nefrologica, Vol. 70, No. 6, 01.12.2018, p. 594-597.

Research output: Contribution to journalArticle

Mantica, Guglielmo ; Simonato, Alchiede ; Du Plessis, Danelo E. ; Maffezzini, Massimo ; De Rose, Aldo F. ; Van Der Merwe, André ; Terrone, Carlo. / The pathologist's role in the detection of rare variants of bladder cancer and analysis of the impact on incidence and type detection. In: Minerva Urologica e Nefrologica. 2018 ; Vol. 70, No. 6. pp. 594-597.
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AU - Mantica, Guglielmo

AU - Simonato, Alchiede

AU - Du Plessis, Danelo E.

AU - Maffezzini, Massimo

AU - De Rose, Aldo F.

AU - Van Der Merwe, André

AU - Terrone, Carlo

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N2 - BACKGROUND: Histology is one of the most important factors determining the prognosis of bladder cancers and rare variants are generally associated with decreased disease specific survival compared to pure transitional cell carcinomas. We believe that rare bladder cancer variants are likely underdiagnosed in the absence of a dedicated uro-pathologist in many centers. The objective of this study is to evaluate the contribution of a dedicated uro-pathologist on the identification of rare bladder cancer variants. METHODS: We retrospectively analyzed the clinical and histological records of all patients which underwent a radical cystectomy and lymph node dissection between January 2000 and September 2015. The sample was divided in two groups: Group A, consists of patients who underwent radical cystectomy in the absence of a dedicated uro-pathologist at our institution, whereas the Group B consists of patients who underwent surgery when a dedicated uro-pathology service was available. We then evaluated the impact of a dedicated uro-pathologist on rare variants detection. RESULTS: One hundred thirty-seven out of 551 (24.9%) of patients who underwent RC had at least one rare variant. In Group A 38/238 (16%) of patients showed a rare variant, while 99/313 (31.6%; P<0.001) in group B. Furthermore, the diagnosis of sarcomatoid variant was statistically significantly less common in group A (P=0.0026). The concordance between final radical cystectomy histology and previous transurethral resection of bladder tumor (TURBT) histology was poor in both groups (overall 50.4%). CONCLUSIONS: The presence of a dedicated urological anatomical pathologist is of paramount importance and significantly increases the detection rate of non-transitional cell carcinoma bladder cancer types, but it does not increase the concordance rate between histological diagnoses in TURBT and radical cystectomy specimens.

AB - BACKGROUND: Histology is one of the most important factors determining the prognosis of bladder cancers and rare variants are generally associated with decreased disease specific survival compared to pure transitional cell carcinomas. We believe that rare bladder cancer variants are likely underdiagnosed in the absence of a dedicated uro-pathologist in many centers. The objective of this study is to evaluate the contribution of a dedicated uro-pathologist on the identification of rare bladder cancer variants. METHODS: We retrospectively analyzed the clinical and histological records of all patients which underwent a radical cystectomy and lymph node dissection between January 2000 and September 2015. The sample was divided in two groups: Group A, consists of patients who underwent radical cystectomy in the absence of a dedicated uro-pathologist at our institution, whereas the Group B consists of patients who underwent surgery when a dedicated uro-pathology service was available. We then evaluated the impact of a dedicated uro-pathologist on rare variants detection. RESULTS: One hundred thirty-seven out of 551 (24.9%) of patients who underwent RC had at least one rare variant. In Group A 38/238 (16%) of patients showed a rare variant, while 99/313 (31.6%; P<0.001) in group B. Furthermore, the diagnosis of sarcomatoid variant was statistically significantly less common in group A (P=0.0026). The concordance between final radical cystectomy histology and previous transurethral resection of bladder tumor (TURBT) histology was poor in both groups (overall 50.4%). CONCLUSIONS: The presence of a dedicated urological anatomical pathologist is of paramount importance and significantly increases the detection rate of non-transitional cell carcinoma bladder cancer types, but it does not increase the concordance rate between histological diagnoses in TURBT and radical cystectomy specimens.

KW - Carcinoma, transitional cell

KW - Cystectomy

KW - Urinary bladder neoplasms

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