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• W1997417249 abstract "No AccessJournal of UrologyAdult Urology: Oncology: Renal/Upper Tract/Bladder1 Sep 2004OUTCOMES IN PATIENTS WITH PATHOLOGICAL CARCINOMA IN SITU ONLY DISEASE AT RADICAL CYSTECTOMY J. MATTHEW HASSAN, MICHAEL S. COOKSON, JOSEPH A. SMITH, DARREN L. JOHNSON, and SAM S. CHANG J. MATTHEW HASSANJ. MATTHEW HASSAN More articles by this author , MICHAEL S. COOKSONMICHAEL S. COOKSON More articles by this author , JOSEPH A. SMITHJOSEPH A. SMITH More articles by this author , DARREN L. JOHNSONDARREN L. JOHNSON More articles by this author , and SAM S. CHANGSAM S. CHANG More articles by this author View All Author Informationhttps://doi.org/10.1097/01.ju.0000136294.15938.3dAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: Pathological stage influences patient outcome after radical cystectomy. We present our experience with patients who have only transitional cell carcinoma in situ of the bladder (pCIS-only) on final pathological examination after radical cystectomy. Materials and Methods: Between August 1995 and June 2003, 576 patients underwent radical cystectomy at our institution. Of these patients 54 were pathological stage CIS-only on final cystectomy specimen. Four patients simultaneously had invasive transitional cell carcinoma of the ureter or renal pelvis and were excluded from evaluation. Variables examined included demographic characteristics, preoperative pathological stage, high risk features and followup parameters. Results: Of the 50 patients with pCIS-only 44 (88%) were disease-free at last followup. Mean followup was 37.2 months (range 3.6 to 93.5). Of the 50 patients 21 had focal CIS while 29 had multifocal disease. There was no difference in disease recurrence between these 2 groups (9.5% vs 13.7%, p = 0.8). There were 9 patients with proximal urethral CIS involvement, of whom metastatic disease developed in 3. Only 1 of the 8 patients (12.5%) with ureteral orifice involvement had recurrence. Of the 50 patients 22 had muscle invasive disease on initial transurethral resection without residual invasive disease at cystectomy. This subset fared significantly worse after radical cystectomy than the 28 patients with less than stage T2 disease on transurethral bladder tumor resection (22.7% vs 3.6% metastasis, p ≤0.05). Conclusions: The outcome of patients who have pCIS-only after radical cystectomy is not uniform. Patients may be at higher risk for recurrence if disease extends to the proximal urethra. In addition, patients demonstrating invasion on clinical staging (stage T2 or greater) but subsequent pCIS-only disease have a worse prognosis compared to those with superficial clinical staging. Patients with CIS-only on clinical and pathological staging have an excellent disease-free survival with radical cystectomy even with the presence of multifocal disease. References 1 : Superficial bladder cancer: progression and recurrence. J Urol1983; 130: 1083. Abstract, Google Scholar 2 : Infiltrating carcinoma of the bladder: relation of depth of penetration of the bladder wall to incidence of local extension and metastases. J Urol1946; 55: 366. Link, Google Scholar 3 : The National Cancer Data Base report on bladder carcinoma. The American College of Surgeons Commission on Cancer and the American Cancer Society. Cancer1996; 78: 1505. Google Scholar 4 : Bladder carcinoma and a TNM system of classification. J Urol1977; 117: 583. Link, Google Scholar 5 : Uncertainty, stage, and outcome of invasive bladder cancer. J Urol1994; 152: 401. Link, Google Scholar 6 : The treated natural history of high risk superficial bladder cancer: 15-year outcome. J Urol1997; 158: 62. Link, Google Scholar 7 : Management of carcinoma in situ of the bladder: the case for surgical management. Urol Clin North Am1980; 7: 533. Google Scholar 8 : Carcinoma in situ of the urinary tract. Urol Clin North Am1984; 11: 735. Google Scholar 9 : Non-invasive papillary carcinoma of the bladder associated with carcinoma in situ. J Urol1976; 116: 575. Link, Google Scholar 10 : Treated history of noninvasive grade 1 transitional cell carcinoma. J Urol1992; 148: 1413. Link, Google Scholar 11 : Does a stage pT0 cystectomy specimen confer a survival advantage in patients with minimally invasive bladder cancer?. J Urol1994; 152: 393. Link, Google Scholar From the Department of Urologic Surgery, Vanderbilt University Medical Center, Nashville, Tennessee© 2004 by American Urological Association, Inc.FiguresReferencesRelatedDetailsCited byTilki D, Reich O, Svatek R, Karakiewicz P, Kassouf W, Novara G, Ficarra V, Chade D, Fritsche H, Gerwens N, Izawa J, Lerner S, Schoenberg M, Stief C, Skinner E, Lotan Y, Sagalowsky A and Shariat S (2018) Characteristics and Outcomes of Patients With Clinical Carcinoma In Situ Only Treated With Radical Cystectomy: An International Study of 243 PatientsJournal of Urology, VOL. 183, NO. 5, (1757-1763), Online publication date: 1-May-2010.Hall M, Chang S, Dalbagni G, Pruthi R, Seigne J, Skinner E, Wolf J and Schellhammer P (2018) Guideline for the Management of Nonmuscle Invasive Bladder Cancer (Stages Ta, T1, and Tis): 2007 UpdateJournal of Urology, VOL. 178, NO. 6, (2314-2330), Online publication date: 1-Dec-2007. Volume 172Issue 3September 2004Page: 882-884 Advertisement Copyright & Permissions© 2004 by American Urological Association, Inc.Keywordscarcinoma, transitional cellcystectomy, carcinoma in situMetricsAuthor Information J. MATTHEW HASSAN More articles by this author MICHAEL S. COOKSON More articles by this author JOSEPH A. SMITH More articles by this author DARREN L. JOHNSON More articles by this author SAM S. CHANG More articles by this author Expand All Advertisement PDF downloadLoading ..." @default.
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• W1997417249 title "OUTCOMES IN PATIENTS WITH PATHOLOGICAL CARCINOMA IN SITU ONLY DISEASE AT RADICAL CYSTECTOMY" @default.
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