TY - JOUR
T1 - Concomitant Carcinoma In Situ Is a Feature of Aggressive Disease in Patients With Organ-Confined TCC at Radical Cystectomy
AU - Shariat, Shahrokh F.
AU - Palapattu, Ganesh S.
AU - Karakiewicz, Pierre I.
AU - Rogers, Craig G.
AU - Vazina, Amnon
AU - Bastian, Patrick J.
AU - Schoenberg, Mark P.
AU - Lerner, Seth P.
AU - Sagalowsky, Arthur I.
AU - Lotan, Yair
N1 - Funding Information:
Shahrokh F. Shariat is supported by the Austrian Program for Advanced Research and Technology.
Copyright:
Copyright 2008 Elsevier B.V., All rights reserved.
PY - 2007/1
Y1 - 2007/1
N2 - Objectives: Carcinoma in situ (CIS) is a nonpapillary, high-grade, potentially aggressive, and unpredictable manifestation of transitional cell carcinoma (TCC) of the bladder. The aim of this study was to assess whether presence of concomitant CIS has a detrimental effect on cancer control after radical cystectomy. Methods: The records of 812 consecutive patients who underwent radical cystectomy and pelvic lymphadenectomy for bladder TCC at three US academic centres were reviewed. Ninety-nine of 812 (12%) patients had CIS only at radical cystectomy and were excluded from the analyses. Results: Three hundred thirty of the 713 (46.3%) patients had concomitant CIS at radical cystectomy. Patients with TCC involvement of the urethra were more likely to have concomitant CIS than not (61% vs. 40%, p = 0.018). Concomitant CIS was significantly more common in patients with lower cystectomy stages and higher tumour grades. In univariate, but not multivariate, analysis, patients with concomitant CIS versus those without were at increased risk of disease recurrence (p = 0.0371). In patients with organ-confined disease, concomitant CIS was an independent predictor of disease recurrence (p = 0.048 and p = 0.012, respectively) but not bladder cancer-specific mortality (p = 0.160 and p = 0.408, respectively) after adjusting for the effects of standard postoperative features. Conclusions: Concomitant CIS in the cystectomy specimen is common, and patients with concomitant CIS are at increased risk of urethral TCC involvement. The presence of concomitant CIS appears to confer a worse prognosis in patients with non-muscle-invasive TCC treated with radical cystectomy.
AB - Objectives: Carcinoma in situ (CIS) is a nonpapillary, high-grade, potentially aggressive, and unpredictable manifestation of transitional cell carcinoma (TCC) of the bladder. The aim of this study was to assess whether presence of concomitant CIS has a detrimental effect on cancer control after radical cystectomy. Methods: The records of 812 consecutive patients who underwent radical cystectomy and pelvic lymphadenectomy for bladder TCC at three US academic centres were reviewed. Ninety-nine of 812 (12%) patients had CIS only at radical cystectomy and were excluded from the analyses. Results: Three hundred thirty of the 713 (46.3%) patients had concomitant CIS at radical cystectomy. Patients with TCC involvement of the urethra were more likely to have concomitant CIS than not (61% vs. 40%, p = 0.018). Concomitant CIS was significantly more common in patients with lower cystectomy stages and higher tumour grades. In univariate, but not multivariate, analysis, patients with concomitant CIS versus those without were at increased risk of disease recurrence (p = 0.0371). In patients with organ-confined disease, concomitant CIS was an independent predictor of disease recurrence (p = 0.048 and p = 0.012, respectively) but not bladder cancer-specific mortality (p = 0.160 and p = 0.408, respectively) after adjusting for the effects of standard postoperative features. Conclusions: Concomitant CIS in the cystectomy specimen is common, and patients with concomitant CIS are at increased risk of urethral TCC involvement. The presence of concomitant CIS appears to confer a worse prognosis in patients with non-muscle-invasive TCC treated with radical cystectomy.
KW - Bladder cancer
KW - Carcinoma in situ
KW - Cystectomy
KW - Recurrence
KW - Survival
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U2 - 10.1016/j.eururo.2006.08.037
DO - 10.1016/j.eururo.2006.08.037
M3 - Article
C2 - 17011114
AN - SCOPUS:33751407204
SN - 0302-2838
VL - 51
SP - 152
EP - 160
JO - European Urology
JF - European Urology
IS - 1
ER -