Prognostic Significance of the Tumor Configuration in Superficial Bladder Tumor

Soonoo Kwon; Chang-myun Park; Han-Gwun Kim; Gil Hyun Gang; Jae Seok Song; Jong Yeon Park

doi:10.4111/kju.2006.47.3.237

Journal List > Korean J Urol > v.47(3) > 1069841

Go to TopGo to Top Go to BottomGo to Bottom

TOOLS

Kwon, Park, Kim, Gang, Song, and Park: Prognostic Significance of the Tumor Configuration in Superficial Bladder Tumor

Original Article

Korean Journal of Urology

Korean Journal of Urology 2006; 47(3): 237-243.

Published online: 31 March 2006

DOI: https://doi.org/10.4111/kju.2006.47.3.237

Prognostic Significance of the Tumor Configuration in Superficial Bladder Tumor

Soonoo Kwon, Chang-myun Park, Han-Gwun Kim, Gil Hyun Gang¹, Jae Seok Song², Jong Yeon Park

Department of Urology, Gangneung Asan Hospital, College of Medicine, Ulsan University, Gangneung, Korea.

¹Department of Pathology, Gangneung Asan Hospital, College of Medicine, Ulsan University, Gangneung, Korea.

²Department of Preventive Medicine and Public Health, College of Medicine, Kwandong University, Gangneung, Korea.

Corresponding author (jypark@gnah.co.kr)

Received 22 July 2005 Accepted 28 November 2005

Abstract

Purpose

The prognostic factors for superficial bladder tumor that affect tumor recurrence and progression have been studied for many years. They are stage, grade, size, multiplicity, microvessel invasion and etc. This study was performed to evaluate the influence of the tumor configuration on predicting its progression and recurrence.

Materials and Methods

128 patients who initially presented with superficial bladder tumor (pTis, pTa and pT1) were retrospectively analyzed according to many factors such as stage, grade, size, multiplicity, microvessel invasion and tumor configuration for tumor progression and recurrence after primary transurethral resection.

Results

48 patients (37.5%) experienced recurrent disease and 20 patients (15.6%) had progressive disease. The absence of stalk and microvessel invasion were the statistically significant factors for recurrence. Only microvessel invasion was a significant prognostic factor for progression.

Conclusions

Only two factors, i.e., the absence of tumor stalk and microvessel invasion, were significant prognostic factors for tumor recurrence. Only microvessel invasion was a significant prognostic factor for tumor progression. When tumors are microvessel invasion positive without stalk after primary transurethral resection, these patients might then benefit from being treated with a more aggressive therapeutic modality.

Keywords: Tumor configuration, Prognostic factor, Bladder tumor

Figures and Tables

Table 1

Tumor stage and grade according to the tumor configuration

PC: papillary cancer, SC: sessile cancer, CIS: carcinoma in situ

Table 2

Distribution of patients (papillary, nonpapillary) according to the tumor stage and grade

^*: using chi-square test

Table 3

Tumor size and multiplicity according to the tumor configuration

PC: papillary cancer, SC: sessile cancer, CIS: carcinoma in situ

Table 4

Microvessel invasion according to the tumor configuration

^*: microvessel invasion positive, ^†: microvessel invasion negative, ^‡: using chi-square test

Table 5

The hazard ratio of recurrence and progression by using multivariate Cox proportional hazard regression analysis

^*: using Cox hazard regression analysis, CIS: carcinoma in situ

References

1. Moyano Calvo JL, Ortiz Gamiz A, Poyato Galan JM, Gutierrez Gonzalez M, Sanchez Sanchez E, Alvarez-Ossorio Fernandez JL, et al. Lymphatic invasion of the bladder wall in T1 superficial bladder carcinoma. Prognostic value. Actas Urol Esp. 2003. 27:260–264.

2. Santos L, Amaro T, Costa C, Pereira S, Bento MJ, Lopes P, et al. Ki-67 index enhances the prognostic accuracy of the urothelial superficial bladder carcinoma risk group classification. Int J Cancer. 2003. 105:267–272.

3. Lorenzo Romero JG, Salinas Sanchez AS, Gimenez Bachs JM, Sanchez Sanchez F, Escribano Martinez J, Hernandez Millan IR, et al. p53 Gene mutations in superficial bladder cancer. Urol Int. 2004. 73:212–218.

4. Shin SM, Chung JY, Noh CH. Predictive value of microstaging in the recurrence and the progression of T1 superficial bladder cancer. Korean J Urol. 1999. 40:1459–1464.

5. Jewett HJ, King LR, Shehelley WM. A study of 365 cases of infiltrating bladder cancer: relation of certain pathological characteristics to prognosis after extirpation. J Urol. 1964. 92:668–678.

6. Cho JS, Lee JM, Lee YT. Prognostic factors in superficial bladder cancer: an analysis of 178 cases. Korean J Urol. 1989. 30:291–300.

7. Park NC, Yoon JB. A clinicopathological study on the urinary bladder tumor-I. survey for the prognostic factor. Korean J Urol. 1984. 25:468–475.

8. Takei K, Hamano M, Ito H, Masai M, Minakami H, Mikami K, et al. Clinical assessment for prognostic factors related to recurrence and progression in superficial bladder cancer. Nippon Hinyokika Gakkai Zasshi. 1995. 86:1416–1423.

9. Brawn PN. The origin of invasive carcinoma of the bladder. Cancer. 1982. 50:515–519.

10. Loening S NA, Yoder L, Slymen D, Penick G, Culp D. Analysis of bladder tumor recurrence in 178 patients. Urology. 1980. 16:137–141.

11. Busto Catanon L, Sanchez Merino JM, Picallo Sanchez JA, Gelabert Mas A. Clinical prognostic factors in superficial cancer of the urinary bladder. Arch Esp Urol. 2001. 54:131–138.

12. Boileau MA, Johnson DE, Chan RC, Gonzales MO. Bladder carcinoma: results with preoperative radiation therapy and radical cystectomy. Urology. 1980. 16:569–576.

13. Chung DY, Cho JH. The factors influencing prognosis of superficial bladder tumor. Korean J Urol. 1990. 31:354–360.

14. Jordan AM, Weigarten J, Murphy WM. Transitional cell neoplasms of the urinary bladder. Can biologic potential be predicted from histologic grading? Cancer. 1987. 60:2766–2774.

15. Soto EA, Friedell GH, Tiltman AJ. Bladder cancer as seen in giant histologic sections. Cancer. 1977. 39:447–455.

16. Heney NM, Proppe K, Prout GR Jr, Griffin PP, Shipley WU. Invasive bladder cancer: tumor configuration, lymphatic invasion and survival. J Urol. 1983. 130:895–897.

17. Anderstrom C, Johansson S, Nilsson S. The significance of lamina propria invasion on the prognosis of patients with bladder tumors. J Urol. 1980. 124:23–26.

18. Prout GR Jr, Griffin PP, Daly JJ, Heney NM. Carcinoma in situ of the urinary bladder with and without associated vesical neoplasms. Cancer. 1983. 52:524–532.

TOOLS

Similar articles