Concomitant carcinoma in situ in cystectomy specimens is not associated with clinical outcomes after surgery

Philipp Nuhn, Patrick J. Bastian, Giacomo Novara, Robert S. Svatek, Pierre I. Karakiewicz, Eila Skinner, Yves Fradet, Jonathan I. Izawa, Wassim Kassouf, Francesco Montorsi, Stefan C. Müller, Hans Martin Fritsche, Guru Sonpavde, Derya Tilki, Hendrik Isbarn, Vincenzo Ficarra, Colin P. Dinney, Shahrokh F. Shariat

Research output: Contribution to journalArticlepeer-review

17 Scopus citations

Abstract

Objective: The aim of this study was to externally validate the prognostic value of concomitant urothelial carcinoma in situ (CIS) in radical cystectomy (RC) specimens using a large international cohort of bladder cancer patients. Methods: The records of 3,973 patients treated with RC and bilateral lymphadenectomy for urothelial carcinoma of the bladder (UCB) at nine centers worldwide were reviewed. Surgical specimens were evaluated by a genitourinary pathologist at each center. Uni- and multivariable Cox regression models addressed time to recurrence and cancer-specific mortality after RC. Results: 1,741 (43.8%) patients had concomitant CIS in their RC specimens. Concomitant CIS was more common in organ-confined UCB and was associated with lymphovascular invasion (p < 0.001). Concomitant CIS was not associated with either disease recurrence or cancer-specific death regardless of pathologic stage. The presence of concomitant CIS did not improve the predictive accuracy of standard predictors for either disease recurrence or cancer-specific death in any of the subgroups. Conclusions: We could not confirm the prognostic value of concomitant CIS in RC specimens. This, together with the discrepancy between pathologists in determining the presence of concomitant CIS at the morphologic level, limits the clinical utility of concomitant CIS in RC specimens for clinical decision-making.

Original languageEnglish (US)
Pages (from-to)42-48
Number of pages7
JournalUrologia Internationalis
Volume87
Issue number1
DOIs
StatePublished - Aug 2011

Keywords

  • Bladder cancer
  • Carcinoma in situ
  • Radical cystectomy, prognosis
  • Urothelial carcinoma, survival

ASJC Scopus subject areas

  • Urology

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