Ureteral and urethral frozen sections during radical cystectomy or cystoprostatectomy

An analysis of denudation and atypia

Jennifer Gordetsky, Trinity Bivalacqua, Mark P. Schoenberg, Jonathan I. Epstein

Research output: Contribution to journalArticle

10 Citations (Scopus)

Abstract

Objective To evaluate denudation (no urothelium present for evaluation) and atypia (urothelial carcinoma in situ [CIS] cannot be ruled out) on frozen sections (FSs) of ureteral and urethral margins in radical cystectomies and cystoprostatectomies. Materials and Methods In radical cystectomies from 2000-2012, we compared FS diagnoses with the corresponding permanent section of the same tissue (frozen section control [FSC]). We also compared FS to "any CIS," which assessed whether there was any CIS in a given ureter or urethra, combining the diagnoses on "frozen section control" and on all submitted ureteral and urethral sections in a case. Results We analyzed 1222 ureteral and 366 urethral FSs in 822 surgical cases. On FS for ureters, there were 56 diagnoses of atypia, 19 (33.9%) of which showed CIS on FSC, and 81 diagnoses of denudation, 1 (1.2%) of which showed CIS on FSC. On FS for urethras, there were 12 diagnoses of atypia, 2 (16.7%) of which showed CIS on FSC, and 17 diagnoses of denudation, 1 (5.9%) of which showed CIS on FSC. Twenty-three patients (38.3%) with atypia and 14 patients (15.0%) with denudation on FS had a finding of "any CIS." A diagnosis of either atypia or denudation on FS was predictive of finding CIS on FSC and "any CIS" in a given ureter or urethra (P <.0001). Half of margins positive for CIS on the first FS were converted to a final negative margin by resecting additional tissue. Conclusion After an FS diagnosis of atypia or denudation, urologists should obtain additional margins if surgically feasible.

Original languageEnglish (US)
Pages (from-to)619-623
Number of pages5
JournalUrology
Volume84
Issue number3
DOIs
StatePublished - 2014
Externally publishedYes

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Cystectomy
Frozen Sections
Carcinoma in Situ
Urethra
Ureter
Urothelium

ASJC Scopus subject areas

  • Urology

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Ureteral and urethral frozen sections during radical cystectomy or cystoprostatectomy : An analysis of denudation and atypia. / Gordetsky, Jennifer; Bivalacqua, Trinity; Schoenberg, Mark P.; Epstein, Jonathan I.

In: Urology, Vol. 84, No. 3, 2014, p. 619-623.

Research output: Contribution to journalArticle

Gordetsky, Jennifer ; Bivalacqua, Trinity ; Schoenberg, Mark P. ; Epstein, Jonathan I. / Ureteral and urethral frozen sections during radical cystectomy or cystoprostatectomy : An analysis of denudation and atypia. In: Urology. 2014 ; Vol. 84, No. 3. pp. 619-623.
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abstract = "Objective To evaluate denudation (no urothelium present for evaluation) and atypia (urothelial carcinoma in situ [CIS] cannot be ruled out) on frozen sections (FSs) of ureteral and urethral margins in radical cystectomies and cystoprostatectomies. Materials and Methods In radical cystectomies from 2000-2012, we compared FS diagnoses with the corresponding permanent section of the same tissue (frozen section control [FSC]). We also compared FS to {"}any CIS,{"} which assessed whether there was any CIS in a given ureter or urethra, combining the diagnoses on {"}frozen section control{"} and on all submitted ureteral and urethral sections in a case. Results We analyzed 1222 ureteral and 366 urethral FSs in 822 surgical cases. On FS for ureters, there were 56 diagnoses of atypia, 19 (33.9{\%}) of which showed CIS on FSC, and 81 diagnoses of denudation, 1 (1.2{\%}) of which showed CIS on FSC. On FS for urethras, there were 12 diagnoses of atypia, 2 (16.7{\%}) of which showed CIS on FSC, and 17 diagnoses of denudation, 1 (5.9{\%}) of which showed CIS on FSC. Twenty-three patients (38.3{\%}) with atypia and 14 patients (15.0{\%}) with denudation on FS had a finding of {"}any CIS.{"} A diagnosis of either atypia or denudation on FS was predictive of finding CIS on FSC and {"}any CIS{"} in a given ureter or urethra (P <.0001). Half of margins positive for CIS on the first FS were converted to a final negative margin by resecting additional tissue. Conclusion After an FS diagnosis of atypia or denudation, urologists should obtain additional margins if surgically feasible.",
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T2 - An analysis of denudation and atypia

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AU - Epstein, Jonathan I.

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N2 - Objective To evaluate denudation (no urothelium present for evaluation) and atypia (urothelial carcinoma in situ [CIS] cannot be ruled out) on frozen sections (FSs) of ureteral and urethral margins in radical cystectomies and cystoprostatectomies. Materials and Methods In radical cystectomies from 2000-2012, we compared FS diagnoses with the corresponding permanent section of the same tissue (frozen section control [FSC]). We also compared FS to "any CIS," which assessed whether there was any CIS in a given ureter or urethra, combining the diagnoses on "frozen section control" and on all submitted ureteral and urethral sections in a case. Results We analyzed 1222 ureteral and 366 urethral FSs in 822 surgical cases. On FS for ureters, there were 56 diagnoses of atypia, 19 (33.9%) of which showed CIS on FSC, and 81 diagnoses of denudation, 1 (1.2%) of which showed CIS on FSC. On FS for urethras, there were 12 diagnoses of atypia, 2 (16.7%) of which showed CIS on FSC, and 17 diagnoses of denudation, 1 (5.9%) of which showed CIS on FSC. Twenty-three patients (38.3%) with atypia and 14 patients (15.0%) with denudation on FS had a finding of "any CIS." A diagnosis of either atypia or denudation on FS was predictive of finding CIS on FSC and "any CIS" in a given ureter or urethra (P <.0001). Half of margins positive for CIS on the first FS were converted to a final negative margin by resecting additional tissue. Conclusion After an FS diagnosis of atypia or denudation, urologists should obtain additional margins if surgically feasible.

AB - Objective To evaluate denudation (no urothelium present for evaluation) and atypia (urothelial carcinoma in situ [CIS] cannot be ruled out) on frozen sections (FSs) of ureteral and urethral margins in radical cystectomies and cystoprostatectomies. Materials and Methods In radical cystectomies from 2000-2012, we compared FS diagnoses with the corresponding permanent section of the same tissue (frozen section control [FSC]). We also compared FS to "any CIS," which assessed whether there was any CIS in a given ureter or urethra, combining the diagnoses on "frozen section control" and on all submitted ureteral and urethral sections in a case. Results We analyzed 1222 ureteral and 366 urethral FSs in 822 surgical cases. On FS for ureters, there were 56 diagnoses of atypia, 19 (33.9%) of which showed CIS on FSC, and 81 diagnoses of denudation, 1 (1.2%) of which showed CIS on FSC. On FS for urethras, there were 12 diagnoses of atypia, 2 (16.7%) of which showed CIS on FSC, and 17 diagnoses of denudation, 1 (5.9%) of which showed CIS on FSC. Twenty-three patients (38.3%) with atypia and 14 patients (15.0%) with denudation on FS had a finding of "any CIS." A diagnosis of either atypia or denudation on FS was predictive of finding CIS on FSC and "any CIS" in a given ureter or urethra (P <.0001). Half of margins positive for CIS on the first FS were converted to a final negative margin by resecting additional tissue. Conclusion After an FS diagnosis of atypia or denudation, urologists should obtain additional margins if surgically feasible.

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