ArticleBladder cancer (Amsterdam, Netherlands)
Under-reporting of carcinoma in situ in patients with high-grade papillary non-muscle-invasive bladder cancer.
Article in Bladder cancer (Amsterdam, Netherlands). The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Concomitant carcinoma in situ (CIS) with high-grade papillary urothelial carcinoma impacts patient risk stratification and treatment. However, on identification of a high-grade papillary lesion, pathologists may be disinclined to search for possible CIS. Several newer agents for bacillus Calmette-Guérin-unresponsive non-muscle-invasive bladder cancer (NMIBC) are indicated specifically for patients with CIS ± papillary tumors; hence failure to detect/report CIS may limit treatment options. Objective: To assess CIS frequency in patients with high-grade Ta/T1 NMIBC. Methods: In this retrospective cohort study, transurethral resection of bladder tumor biopsy specimens with an accompanying diagnosis of high-grade papillary NMIBC without CIS were identified in the PathNet database (2023-2024) and re-reviewed by a single pathologist for the presence of concomitant CIS. Results: In total, 316 cases of high-grade papillary urothelial carcinoma (254 Ta, 62 T1 disease) were identified for re-review. Mean patient age was 73 (range 27-93) years; 81.0% of patients were male. On re-review, CIS was identified in 80 cases (25.3%, 95% CI 20.8%-30.4%). CIS frequency was higher in T1 disease (19/62 cases [30.6%]) Conclusion: This study suggests that ∼25% of patients with high-grade papillary urothelial carcinoma may have unreported CIS. Close communication between the urologist and pathologist is crucial in ensuring specific exclusion of CIS in all bladder specimens, since a diagnosis of concomitant CIS may impact patient management.
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