Skip to main content

Non-Muscle-Invasive Low- and High-Grade Neoplasia

  • Chapter
  • First Online:
The Urinary Tract

Abstract

Bladder cancer imposes a considerable burden on patients and health care systems around the world. Estimates predict more than 70,000 new cases of bladder cancer and more than 14,000 deaths in 2010 in the USA [1]. Bladder cancer is three times more common in men than in women and roughly twice as common in Caucasians as African-Americans. For unknown reasons, relative mortality rates are lower for men and for Caucasians [2, 3]. The risk of bladder cancer increases with age, peaking between the sixth and eighth decades of life, creating unique challenges in treatment related to existing comorbidities [4, 5]. At the time of diagnosis, 75 % of patients present with nonmuscle-invasive bladder cancers (NMIBC); 70–80 % are limited to the mucosa (Ta, Tis) and the remaining 20–30 % invade the lamina propria (T1) [6].

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 89.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 119.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 169.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Jemal A, Siegel R, Xu J, Ward E, Cancer statistics. CA Cancer J Clin. 2010;60(5):277–300.

    Article  PubMed  Google Scholar 

  2. Hall MC, Chang SS, Dalbagni G, Pruthi RS, Seigne JD, Skinner EC, et al. Guideline for the management of non-muscle invasive bladder cancer (stages Ta, T1, and Tis): 2007 update. J Urol. 2007;178(6):2314–30.

    Article  PubMed  Google Scholar 

  3. Messing EM. Urothelial tumors of the bladder. In: Wein AJ, Kavoussi LR, Novick AC, Partin AW, Peters CA, editors. Campbell-Walsh urology. 9th ed. Philadelphia: Saunders-Elsevier; 2007.

    Google Scholar 

  4. Montie JE, Clark PE, Eisenberger MA, El-Galley R, Greenberg RE, Herr HW, et al. Bladder cancer. J Natl Compr Canc Netw. 2009;7(1):8–39.

    PubMed  Google Scholar 

  5. Jacobs BL, Lee CT, Montie JE. Bladder cancer in 2010: how far have we come? CA Cancer J Clin. 2010:caac.20077.

    Google Scholar 

  6. Soloway MS, Sofer M, Vaidya A. Contemporary management of stage T1 transitional cell carcinoma of the bladder. J Urol. 2002;167(4):1573–83.

    Article  PubMed  Google Scholar 

  7. Botteman MF, Pashos CL, Redaelli A, Laskin B, Hauser R. The health economics of bladder cancer: a comprehensive review of the published literature. Pharmacoeconomics. 2003;21(18):1315–30.

    Article  PubMed  Google Scholar 

  8. Epstein JI, Amin MB, Reuter VR, Mostofi FK. The World Health Organization/International Society of Urological Pathology consensus classification of urothelial (transitional cell) neoplasms of the urinary bladder. Bladder Consensus Conference Committee. Am J Surg Pathol. 1998;22(12):1435–48.

    Article  PubMed  CAS  Google Scholar 

  9. Kaufman DS, Shipley WU, Feldman AS. Bladder cancer. Lancet. 2009;374(9685):239–49.

    Article  PubMed  CAS  Google Scholar 

  10. Jones SMD, Campbell SMDPD. Non-muscle-invasive bladder cancer (Ta, T1, and CIS). In: Wein AJ, Kavoussi LR, Novick AC, Partin AW, Peters CA, editors. Campbell-Walsh urology. 9th ed. Philadelphia: Saunders Elsevier; 2007.

    Google Scholar 

  11. Haleblian GE, Skinner EC, Dickinson MG, Lieskovsky G, Boyd SD, Skinner DG. Hydronephrosis as a prognostic indicator in bladder cancer patients. J Urol. 1998;160(6 Pt 1):2011–4.

    PubMed  CAS  Google Scholar 

  12. Strope SA, Montie JE. The causal role of cigarette smoking in bladder cancer initiation and progression, and the role of urologists in smoking cessation. J Urol. 2008;180(1):31–7; discussion 7.

    Google Scholar 

  13. Wynder EL, Goldsmith R. The epidemiology of bladder cancer: a second look. Cancer. 1977;40(3):1246–68.

    Article  PubMed  CAS  Google Scholar 

  14. Golijanin DJ, Kakiashvili D, Madeb RR, Messing EM, Lerner SP. Chemoprevention of bladder cancer. World J Urol. 2006;24(5):445–72.

    Article  PubMed  Google Scholar 

  15. Lamm SH, Engel A, Penn CA, Chen R, Feinleib M. Arsenic cancer risk confounder in southwest Taiwan data set. Environ Health Perspect. 2006;114(7):1077–82.

    Article  PubMed  CAS  Google Scholar 

  16. Silverman DT, Levin LI, Hoover RN. Occupational risks of bladder cancer in the United States: II Nonwhite men. J Natl Cancer Inst. 1989;81(19):1480–3.

    Article  PubMed  CAS  Google Scholar 

  17. Silverman DT, Levin LI, Hoover RN, Hartge P. Occupational risks of bladder cancer in the United States: I. White men. J Natl Cancer Inst. 1989;81(19):1472–80.

    Article  PubMed  CAS  Google Scholar 

  18. Choi JY, Lee KM, Cho SH, Kim SW, Choi HY, Lee SY, et al. CYP2E1 and NQO1 genotypes, smoking and bladder cancer. Pharmacogenetics. 2003;13(6):349–55.

    Article  PubMed  CAS  Google Scholar 

  19. Engel LS, Taioli E, Pfeiffer R, Garcia-Closas M, Marcus PM, Lan Q, et al. Pooled analysis and meta-analysis of glutathione S-transferase M1 and bladder cancer: a HuGE review. Am J Epidemiol. 2002;156(2):95–109.

    Article  PubMed  Google Scholar 

  20. Marcus PM, Vineis P, Rothman N. NAT2 slow acetylation and bladder cancer risk: a meta-analysis of 22 case–control studies conducted in the general population. Pharmacogenetics. 2000;10(2):115–22.

    Article  PubMed  CAS  Google Scholar 

  21. Cordon-Cardo C, Zhang ZF, Dalbagni G, Drobnjak M, Charytonowicz E, Hu SX, et al. Cooperative effects of p53 and pRB alterations in primary superficial bladder tumors. Cancer Res. 1997;57(7):1217–21.

    PubMed  CAS  Google Scholar 

  22. Esrig D, Elmajian D, Groshen S, Freeman JA, Stein JP, Chen SC, et al. Accumulation of nuclear p53 and tumor progression in bladder cancer. N Engl J Med. 1994;331(19):1259–64.

    Article  PubMed  CAS  Google Scholar 

  23. Grossman HB, Liebert M, Antelo M, Dinney CP, Hu SX, Palmer JL, et al. p53 and RB expression predict progression in T1 bladder cancer. Clin Cancer Res. 1998;4(4):829–34.

    PubMed  CAS  Google Scholar 

  24. Shinohara N, Koyanagi T. Ras signal transduction in carcinogenesis and progression of bladder cancer: molecular target for treatment? Urol Res. 2002;30(5):273–81.

    Article  PubMed  CAS  Google Scholar 

  25. Theodorescu D. Molecular pathogenesis of proliferative and progressive (invasive) urothelial cancer. In: Droller MJ, Goldsmith K, Goldsmith C, editors. Urothelial tumors. Hamilton, British Colombia: Decker; 2004. p. 28–43.

    Google Scholar 

  26. Hazra AG, Gu J, Wu X. Genetic susceptibility to bladder cancer. In: Lerner SP, Schoenberg MP, Sternberg CN, editors. Textbook of bladder cancer. Oxford: Taylor and Francis; 2006. p. 2–36.

    Google Scholar 

  27. Mellon K, Wright C, Kelly P, Horne CH, Neal DE. Long-term outcome related to epidermal growth factor receptor status in bladder cancer. J Urol. 1995;153(3 Pt 2):919–25.

    PubMed  CAS  Google Scholar 

  28. Messing EM. Clinical implications of the expression of epidermal growth factor receptors in human ­transitional cell carcinoma. Cancer Res. 1990;50(8):2530–7.

    PubMed  CAS  Google Scholar 

  29. Neal DE, Sharples L, Smith K, Fennelly J, Hall RR, Harris AL. The epidermal growth factor receptor and the prognosis of bladder cancer. Cancer. 1990;65(7):1619–25.

    Article  PubMed  CAS  Google Scholar 

  30. Herr HW. Tumour progression and survival in patients with T1G3 bladder tumours: 15-year outcome. Br J Urol. 1997;80(5):762–5.

    Article  PubMed  CAS  Google Scholar 

  31. Saad A, Hanbury DC, McNicholas TA, Boustead GB, Morgan S, Woodman AC. A study comparing various noninvasive methods of detecting bladder cancer in urine. BJU Int. 2002;89(4):369–73.

    Article  PubMed  CAS  Google Scholar 

  32. Sylvester RJ, van der Meijden AP, Lamm DL. Intravesical bacillus Calmette-Guerin reduces the risk of progression in patients with superficial ­bladder cancer: a meta-analysis of the published results of randomized clinical trials. J Urol. 2002;168(5):1964–70.

    Article  PubMed  CAS  Google Scholar 

  33. Smits G, Schaafsma E, Kiemeney L, Caris C, Debruyne F, Witjes JA. Microstaging of pT1 transitional cell carcinoma of the bladder: identification of subgroups with distinct risks of progression. Urology. 1998;52(6):1009–13; discussion 13–4.

    Google Scholar 

  34. Herr HW. Tumor progression and survival of patients with high grade, noninvasive papillary (TaG3) bladder tumors: 15-year outcome. J Urol. 2000;163(1):60–1; discussion 1–2.

    Google Scholar 

  35. Droller MJ. Biological considerations in the assessment of urothelial cancer: a retrospective. Urology. 2005;66(5 Suppl):66–75.

    Article  PubMed  Google Scholar 

  36. Richter J, Jiang F, Gorog JP, Sartorius G, Egenter C, Gasser TC, et al. Marked genetic differences between stage pTa and stage pT1 papillary bladder cancer detected by comparative genomic hybridization. Cancer Res. 1997;57(14):2860–4.

    PubMed  CAS  Google Scholar 

  37. Degtyar P, Neulander E, Zirkin H, Yusim I, Douvdevani A, Mermershtain W, et al. Fluorescence in situ hybridization performed on exfoliated urothelial cells in patients with transitional cell carcinoma of the bladder. Urology. 2004;63(2):398–401.

    Article  PubMed  Google Scholar 

  38. Wu XR. Urothelial tumorigenesis: a tale of divergent pathways. Nat Rev Cancer. 2005;5(9):713–25.

    Article  PubMed  CAS  Google Scholar 

  39. Glas AS, Roos D, Deutekom M, Zwinderman AH, Bossuyt PM, Kurth KH. Tumor markers in the diagnosis of primary bladder cancer. A systematic review. J Urol. 2003;169(6):1975–82.

    Article  PubMed  Google Scholar 

  40. Nabi G, Greene D, O’Donnell MO. Suspicious urinary cytology with negative evaluation for malignancy in the diagnostic investigation of haematuria: how to follow up? J Clin Pathol. 2004;57(4):365–8.

    Article  PubMed  CAS  Google Scholar 

  41. Halling KC, King W, Sokolova IA, Meyer RG, Burkhardt HM, Halling AC, et al. A comparison of cytology and fluorescence in situ hybridization for the detection of urothelial carcinoma. J Urol. 2000;164(5):1768–75.

    Article  PubMed  CAS  Google Scholar 

  42. Lokeshwar VB, Habuchi T, Grossman HB, Murphy WM, Hautmann SH, Hemstreet 3rd GP, et al. Bladder tumor markers beyond cytology: International Consensus Panel on bladder tumor markers. Urology. 2005;66(6 Suppl 1):35–63.

    Article  PubMed  Google Scholar 

  43. Paik ML, Scolieri MJ, Brown SL, Spirnak JP, Resnick MI. Limitations of computerized tomography in staging invasive bladder cancer before radical cystectomy. J Urol. 2000;163(6):1693–6.

    Article  PubMed  CAS  Google Scholar 

  44. Saksena MA, Dahl DM, Harisinghani MG. New imaging modalities in bladder cancer. World J Urol. 2006;24(5):473–80.

    Article  PubMed  Google Scholar 

  45. Arslan H, Ceylan K, Harman M, Yilmaz Y, Temizoz O, Can S. Virtual computed tomography cystoscopy in bladder pathologies. Int Braz J Urol. 2006;32(2):147–54; discussion 54.

    Google Scholar 

  46. Kibel AS, Dehdashti F, Katz MD, Klim AP, Grubb RL, Humphrey PA, et al. Prospective study of [18F]fluorodeoxyglucose positron emission tomography/computed tomography for staging of muscle-invasive bladder carcinoma. J Clin Oncol. 2009;27(26):4314–20.

    Article  PubMed  Google Scholar 

  47. Tekes A, Kamel I, Imam K, Szarf G, Schoenberg M, Nasir K, et al. Dynamic MRI of bladder cancer: evaluation of staging accuracy. AJR Am J Roentgenol. 2005;184(1):121–7.

    PubMed  Google Scholar 

  48. Cina SJ, Epstein JI, Endrizzi JM, Harmon WJ, Seay TM, Schoenberg MP. Correlation of cystoscopic impression with histologic diagnosis of biopsy specimens of the bladder. Hum Pathol. 2001;32(6):630–7.

    Article  PubMed  CAS  Google Scholar 

  49. Mitropoulos D, Kiroudi-Voulgari A, Nikolopoulos P, Manousakas T, Zervas A. Accuracy of cystoscopy in predicting histologic features of bladder lesions. J Endourol. 2005;19(7):861–4.

    Article  PubMed  CAS  Google Scholar 

  50. Grossman HB, Gomella L, Fradet Y, Morales A, Presti J, Ritenour C, et al. A phase III, multicenter comparison of hexaminolevulinate fluorescence cystoscopy and white light cystoscopy for the detection of superficial papillary lesions in patients with bladder cancer. J Urol. 2007;178(1):62–7.

    Article  PubMed  Google Scholar 

  51. Babjuk M, Soukup V, Petrik R, Jirsa M, Dvoracek J. 5-aminolaevulinic acid-induced fluorescence cystoscopy during transurethral resection reduces the risk of recurrence in stage Ta/T1 bladder cancer. BJU Int. 2005;96(6):798–802.

    Article  PubMed  CAS  Google Scholar 

  52. Riedl CR, Daniltchenko D, Koenig F, Simak R, Loening SA, Pflueger H. Fluorescence endoscopy with 5-aminolevulinic acid reduces early recurrence rate in superficial bladder cancer. J Urol. 2001;165(4):1121–3.

    Article  PubMed  CAS  Google Scholar 

  53. Denzinger S, Burger M, Walter B, Knuechel R, Roessler W, Wieland WF, et al. Clinically relevant reduction in risk of recurrence of superficial bladder cancer using 5-aminolevulinic acid-induced fluorescence diagnosis: 8-year results of prospective randomized study. Urology. 2007;69(4):675–9.

    Article  PubMed  Google Scholar 

  54. Herr HW, Donat SM. A comparison of white-light cystoscopy and narrow-band imaging cystoscopy to detect bladder tumour recurrences. BJU Int. 2008;102(9):1111–4.

    Article  PubMed  Google Scholar 

  55. Goh AC, Tresser NJ, Shen SS, Lerner SP. Optical coherence tomography as an adjunct to white light cystoscopy for intravesical real-time imaging and staging of bladder cancer. Urology. 2008;72(1):133–7.

    Article  PubMed  Google Scholar 

  56. Sonn GA, Jones SN, Tarin TV, Du CB, Mach KE, Jensen KC, et al. Optical biopsy of human bladder neoplasia with in vivo confocal laser endomicroscopy. J Urol. 2009;182(4):1299–305.

    Article  PubMed  Google Scholar 

  57. Oyasu R. World Health Organization and International Society of Urological Pathology classification and two-number grading system of bladder tumors. Cancer. 2000;88(7):1509–12.

    Article  PubMed  CAS  Google Scholar 

  58. Loening S, Narayana A, Yoder L, Slymen D, Penick G, Culp D. Analysis of bladder tumor recurrence in 178 patients. Urology. 1980;16(2):137–41.

    Article  PubMed  CAS  Google Scholar 

  59. Eble JN, Sauter G, Epstein J, Sesterhenn I, editors. Pathology and genetics of tumours of the urinary system and male genital organs. Lyon: IARC press; 2004.

    Google Scholar 

  60. McKenney JK, Desai S, Cohen C, Amin MB. Discriminatory immunohistochemical staining of urothelial carcinoma in situ and non-neoplastic urothelium: an analysis of cytokeratin 20, p53, and CD44 antigens. Am J Surg Pathol. 2001;25(8):1074–8.

    Article  PubMed  CAS  Google Scholar 

  61. Murphy WM, Beckwith JB, Farrow GM. Tumors of the kidney, bladder and related urinary structures. In: Rosai J, editor. Atlas of tumor pathology. Washington, D.C.: Armed Forces Institute of Pathology; 1994.

    Google Scholar 

  62. Murphy WM. Current topics in the pathology of bladder cancer. Pathol Annu. 1983;18(Pt 1):1–25.

    PubMed  Google Scholar 

  63. Murphy WM, Irving CC. The cellular features of developing carcinoma in murine urinary bladder. Cancer. 1981;47(3):514–22.

    Article  PubMed  CAS  Google Scholar 

  64. Murphy WM, Soloway MS. Developing carcinoma (dysplasia) of the urinary bladder. Pathol Annu. 1982;17(Pt 1):197–217.

    PubMed  Google Scholar 

  65. Nagy GK, Frable WJ, Murphy WM. Classification of premalignant urothelial abnormalities. A Delphi study of the National Bladder Cancer Collaborative Group A. Pathol Annu. 1982;17(Pt 1):219–33.

    PubMed  Google Scholar 

  66. Koss LG, Nakanishi I, Freed SZ. Nonpapillary carcinoma in situ and atypical hyperplasia in cancerous bladders: further studies of surgically removed bladders by mapping. Urology. 1977;9(4):442–55.

    Article  PubMed  CAS  Google Scholar 

  67. Murphy WM, Nagy GK, Rao MK, Soloway MS, Parija GC, Cox 2nd CE, et al. “Normal” urothelium in patients with bladder cancer: a preliminary report from the National Bladder Cancer Collaborative Group A. Cancer. 1979;44(3):1050–8.

    Article  PubMed  CAS  Google Scholar 

  68. Prout Jr GR, Griffin PP, Daly JJ, Heney NM. Carcinoma in situ of the urinary bladder with and without associated vesical neoplasms. Cancer. 1983;52(3):524–32.

    Article  PubMed  Google Scholar 

  69. Kakizoe T, Matumoto K, Nishio Y, Ohtani M, Kishi K. Significance of carcinoma in situ and dysplasia in association with bladder cancer. J Urol. 1985;133(3):395–8.

    PubMed  CAS  Google Scholar 

  70. Utz DC, Farrow GM, Rife CC, Segura JW, Zincke H. Carcinoma in situ of the bladder. Cancer. 1980;45(7 Suppl):1842–8.

    PubMed  CAS  Google Scholar 

  71. Zincke H, Utz DC. Review of Mayo Clinic ­experience with carcinoma in situ. Urology. 1986;27(3):288.

    Article  PubMed  CAS  Google Scholar 

  72. Melamed MR, Voutsa NG, Grabstald H. Natural history and clinical behavior of in situ carcinoma of the human urinary bladder. 1964. CA Cancer J Clin. 1993;43(6):348–70.

    Article  PubMed  CAS  Google Scholar 

  73. Farrow GM, Utz DC, Rife CC, Greene LF. Clinical observations on sixty-nine cases of in situ carcinoma of the urinary bladder. Cancer Res. 1977;37(8 Pt 2):2794–8.

    PubMed  CAS  Google Scholar 

  74. Weinstein RS, Miller 3rd AW, Pauli BU. Carcinoma in situ: comments on the pathobiology of a paradox. Urol Clin North Am. 1980;7(3):523–31.

    PubMed  CAS  Google Scholar 

  75. Mostofi FK, Sobin LH, Torloni H. Histological ­typing of urinary bladder tumors: international classification of tumors. 10th ed. Geneva: WHO, editor; 1973.

    Google Scholar 

  76. Epstein JI. The new World Health Organization/International Society of Urological Pathology (WHO/ISUP) classification for TA, T1 bladder tumors: is it an improvement? Crit Rev Oncol Hematol. 2003;47(2):83–9.

    Article  PubMed  Google Scholar 

  77. Abel PD, Henderson D, Bennett MK, Hall RR, Williams G. Differing interpretations by pathologists of the pT category and grade of transitional cell cancer of the bladder. Br J Urol. 1988;62(4):339–42.

    Article  PubMed  CAS  Google Scholar 

  78. Pich A, Chiusa L, Formiconi A, Galliano D, Bortolin P, Navone R. Biologic differences between noninvasive papillary urothelial neoplasms of low malignant potential and low-grade (grade 1) papillary carcinomas of the bladder. Am J Surg Pathol. 2001;25(12):1528–33.

    Article  PubMed  CAS  Google Scholar 

  79. Samaratunga H, Makarov DV, Epstein JI. Comparison of WHO/ISUP and WHO classification of noninvasive papillary urothelial neoplasms for risk of progression. Urology. 2002;60(2):315–9.

    Article  PubMed  Google Scholar 

  80. Bircan S, Candir O, Serel TA. Comparison of WHO 1973, WHO/ISUP 1998, WHO 1999 grade and combined scoring systems in evaluation of bladder carcinoma. Urol Int. 2004;73(3):201–8.

    Article  PubMed  Google Scholar 

  81. Genega EM, Kapali M, Torres-Quinones M, Huang WC, Knauss JS, Wang L-P, et al. Impact of the 1998 World Health Organization//International Society of Urological Pathology classification system for urothelial neoplasms of the kidney. Mod Pathol. 2004;18(1):11–8.

    Article  Google Scholar 

  82. Gonul II, Poyraz A, Unsal C, Acar C, Alkibay T. Comparison of 1998 WHO/ISUP and 1973 WHO classifications for interobserver variability in grading of papillary urothelial neoplasms of the bladder. Pathological evaluation of 258 cases. Urol Int. 2007;78(4):338–44.

    Article  PubMed  Google Scholar 

  83. Burger M, Denzinger S, Wieland W-F, Stief CG, Hartmann A, Zaak D. Does the current World Health Organization classification predict the outcome better in patients with noninvasive bladder cancer of early or regular onset? BJU Int. 2008;102(2):194–7.

    Article  PubMed  Google Scholar 

  84. Oosterhuis JWA, Schapers RFM, Janssen-Heijnen MLG, Pauwels RPE, Newling DW, ten Kate F. Histological grading of papillary urothelial carcinoma of the bladder: prognostic value of the 1998 WHO/ISUP classification system and comparison with conventional grading systems. J Clin Pathol. 2002;55(12):900–5.

    Article  PubMed  CAS  Google Scholar 

  85. Yorukoglu K, Tuna B, Dikicioglu E, Duzcan E, Isisag A, Sen S, et al. Reproducibility of the 1998 World Health Organization/International Society of Urologic Pathology classification of papillary urothelial neoplasms of the urinary bladder. Virchows Arch. 2003;443(6):734–40.

    Article  PubMed  Google Scholar 

  86. Cheng L, Darson M, Cheville JC, Neumann RM, Zincke H, Nehra A, et al. Urothelial papilloma of the bladder. Clinical and biologic implications. Cancer. 1999;86(10):2098–101.

    Article  PubMed  CAS  Google Scholar 

  87. McKenney JK, Amin MB, Young RH. Urothelial (transitional cell) papilloma of the urinary bladder: a clinicopathologic study of 26 cases. Mod Pathol. 2003;16(7):623–9.

    Article  PubMed  Google Scholar 

  88. Holmang S, Andius P, Hedelin H, Wester K, Busch C, Johansson SL. Stage progression in Ta papillary urothelial tumors: relationship to grade, immunohistochemical expression of tumor markers, mitotic frequency and DNA ploidy. J Urol. 2001;165(4):1124–8; discussion 8–30.

    Google Scholar 

  89. Miyamoto H, Miller JS, Fajardo DA, Lee TK, Netto GJ, Epstein JI. Non-invasive papillary urothelial neoplasms: the 2004 WHO/ISUP classification system. Pathol Int. 2010;60(1):1–8.

    Article  PubMed  Google Scholar 

  90. Desai S, Lim SD, Jimenez RE, Chun T, Keane TE, McKenney JK, et al. Relationship of cytokeratin 20 and CD44 protein expression with WHO/ISUP grade in pTa and pT1 papillary urothelial neoplasia. Mod Pathol. 2000;13(12):1315–23.

    Article  PubMed  CAS  Google Scholar 

  91. MacLennan GT, Kirkali Z, Cheng L. Histologic grading of noninvasive papillary urothelial neoplasms. Eur Urol. 2007;51(4):889–97; discussion 97–8.

    Google Scholar 

  92. Murphy WM, Takezawa K, Maruniak NA. Interobserver discrepancy using the 1998 World Health Organization/International Society of Urologic Pathology classification of urothelial neoplasms: practical choices for patient care. J Urol. 2002;168(3):968–72.

    Article  PubMed  Google Scholar 

  93. Lamina propria microinvasion of bladder tumors, incidence on stage allocation (pTa vs pT1): recommended approach. Pathologists of the French Association of Urology Cancer Committee. World J Urol. 1993;11(3):161–4.

    Google Scholar 

  94. Bol MG, Baak JP, Buhr-Wildhagen S, Kruse AJ, Kjellevold KH, Janssen EA, et al. Reproducibility and prognostic variability of grade and lamina propria invasion in stages Ta, T1 urothelial carcinoma of the bladder. J Urol. 2003;169(4):1291–4.

    Article  PubMed  Google Scholar 

  95. Tosoni I, Wagner U, Sauter G, Egloff M, Knonagel H, Alund G, et al. Clinical significance of interobserver differences in the staging and grading of superficial bladder cancer. BJU Int. 2000;85(1):48–53.

    Article  PubMed  CAS  Google Scholar 

  96. Lopez-Beltran A, Cheng L. Stage pT1 bladder carcinoma: diagnostic criteria, pitfalls and prognostic significance. Pathology. 2003;35(6):484–91.

    Article  PubMed  Google Scholar 

  97. Jimenez RE, Keane TE, Hardy HT, Amin MB. pT1 urothelial carcinoma of the bladder: criteria for diagnosis, pitfalls, and clinical implications. Adv Anat Pathol. 2000;7(1):13–25.

    Article  PubMed  CAS  Google Scholar 

  98. Dhall D, Al-Ahmadie H, Olgac S. Nested variant of urothelial carcinoma. Arch Pathol Lab Med. 2007;131(11):1725–7.

    PubMed  Google Scholar 

  99. Young RH, Zukerberg LR. Microcystic transitional cell carcinomas of the urinary bladder. A report of four cases. Am J Clin Pathol. 1991;96(5):635–9.

    PubMed  CAS  Google Scholar 

  100. Drew PA, Furman J, Civantos F, Murphy WM. The nested variant of transitional cell carcinoma: an aggressive neoplasm with innocuous histology. Mod Pathol. 1996;9(10):989–94.

    PubMed  CAS  Google Scholar 

  101. Younes M, Sussman J, True LD. The usefulness of the level of the muscularis mucosae in the staging of invasive transitional cell carcinoma of the urinary bladder. Cancer. 1990;66(3):543–8.

    Article  PubMed  CAS  Google Scholar 

  102. Holmang S, Hedelin H, Anderstrom C, Holmberg E, Johansson SL. The importance of the depth of ­invasion in stage T1 bladder carcinoma: a prospective cohort study. J Urol. 1997;157(3):800–3; ­discussion 4.

    Google Scholar 

  103. Chan TY, Epstein JI. In situ adenocarcinoma of the bladder. Am J Surg Pathol. 2001;25(7):892–9.

    Article  PubMed  CAS  Google Scholar 

  104. Lim M, Adsay NV, Grignon D, Osunkoya AO. Urothelial carcinoma with villoglandular differentiation: a study of 14 cases. Mod Pathol. 2009;22(10):1280–6.

    Article  PubMed  Google Scholar 

  105. Miller JS, Epstein JI. Noninvasive urothelial carcinoma of the bladder with glandular differentiation: report of 24 cases. Am J Surg Pathol. 2009;33(8):1241–8.

    Article  PubMed  Google Scholar 

  106. Guo CC, Fine SW, Epstein JI. Noninvasive squamous lesions in the urinary bladder: a clinicopathologic analysis of 29 cases. Am J Surg Pathol. 2006;30(7):883–91.

    Article  PubMed  Google Scholar 

  107. Ahmad I, Barnetson RJ, Krishna NS. Keratinizing squamous metaplasia of the bladder: a review. Urol Int. 2008;81(3):247–51.

    Article  PubMed  Google Scholar 

  108. Nieder AM, Brausi M, Lamm D, O’Donnell M, Tomita K, Woo H, et al. Management of stage T1 tumors of the bladder: International Consensus Panel. Urology. 2005;66(6 Suppl 1):108–25.

    Article  PubMed  Google Scholar 

  109. Fujimoto N, Harada S, Terado M, Sato H, Matsumoto T. Multiple biopsies of normal-looking urothelium in patients with superficial bladder cancer: are they necessary? Int J Urol. 2003;10(12):631–5.

    Article  PubMed  Google Scholar 

  110. van der Meijden A, Oosterlinck W, Brausi M, Kurth KH, Sylvester R, de Balincourt C. Significance of bladder biopsies in Ta, T1 bladder tumors: a report from the EORTC Genito-Urinary Tract Cancer Cooperative Group. EORTC-GU Group Superficial Bladder Committee. Eur Urol. 1999;35(4):267–71.

    Article  PubMed  Google Scholar 

  111. Miladi M, Peyromaure M, Zerbib M, Saighi D, Debre B. The value of a second transurethral resection in evaluating patients with bladder tumours. Eur Urol. 2003;43(3):241–5.

    Article  PubMed  Google Scholar 

  112. Herr HW. The value of a second transurethral resection in evaluating patients with bladder tumors. J Urol. 1999;162(1):74–6.

    Article  PubMed  CAS  Google Scholar 

  113. Schwaibold HE, Sivalingam S, May F, Hartung R. The value of a second transurethral resection for T1 bladder cancer. BJU Int. 2006;97(6):1199–201.

    Article  PubMed  Google Scholar 

  114. Dutta SC, Smith Jr JA, Shappell SB, Coffey CS, Chang SS, Cookson MS. Clinical under staging of high risk non-muscle invasive urothelial carcinoma treated with radical cystectomy. J Urol. 2001;166(2):490–3.

    Article  PubMed  CAS  Google Scholar 

  115. Herr HW, Donat SM, Dalbagni G. Can restaging transurethral resection of T1 bladder cancer select patients for immediate cystectomy? J Urol. 2007;177(1):75–9; discussion 9.

    Google Scholar 

  116. Herr HW. Restaging transurethral resection of high risk superficial bladder cancer improves the initial response to bacillus Calmette-Guerin therapy. J Urol. 2005;174(6):2134–7.

    Article  PubMed  Google Scholar 

  117. Lee CT, Dunn RL, Ingold C, Montie JE, Wood Jr DP. Early-stage bladder cancer surveillance does not improve survival if high-risk patients are permitted to progress to muscle invasion. Urology. 2007;69(6):1068–72.

    Article  PubMed  Google Scholar 

  118. Wasco MJ, Daignault S, Zhang Y, Kunju LP, Kinnaman M, Braun T, et al. Urothelial carcinoma with divergent histologic differentiation (mixed histologic features) predicts the presence of locally advanced bladder cancer when detected at transurethral resection. Urology. 2007;70(1):69–74.

    Article  PubMed  Google Scholar 

  119. Kamat AM, Gee JR, Dinney CP, Grossman HB, Swanson DA, Millikan RE, et al. The case for early cystectomy in the treatment of non-muscle invasive micropapillary bladder carcinoma. J Urol. 2006;175(3 Pt 1):881–5.

    Article  PubMed  Google Scholar 

  120. Lin O, Cardillo M, Dalbagni G, Linkov I, Hutchinson B, Reuter VE. Nested variant of urothelial carcinoma: a clinicopathologic and immunohistochemical study of 12 cases. Mod Pathol. 2003;16(12):1289–98.

    Article  PubMed  Google Scholar 

  121. Dahm P, Gschwend JE. Malignant non-urothelial neoplasms of the urinary bladder: a review. Eur Urol. 2003;44(6):672–81.

    Article  PubMed  Google Scholar 

  122. Rogers CG, Palapattu GS, Shariat SF, Karakiewicz PI, Bastian PJ, Lotan Y, et al. Clinical outcomes following radical cystectomy for primary nontransitional cell carcinoma of the bladder compared to transitional cell carcinoma of the bladder. J Urol. 2006;175(6):2048–53; discussion 53.

    Google Scholar 

  123. Nigwekar P, Tamboli P, Amin MB, Osunkoya AO, Ben-Dor D, Amin MB. Plasmacytoid urothelial carcinoma: detailed analysis of morphology with clinicopathologic correlation in 17 cases. Am J Surg Pathol. 2009;33(3):417–24.

    Article  PubMed  Google Scholar 

  124. Siefker-Radtke AO, Dinney CP, Abrahams NA, Moran C, Shen Y, Pisters LL, et al. Evidence supporting preoperative chemotherapy for small cell carcinoma of the bladder: a retrospective review of the MD. Anderson cancer experience. J Urol. 2004;172(2):481–4.

    Article  PubMed  Google Scholar 

  125. Siefker-Radtke AO, Kamat AM, Grossman HB, Williams DL, Qiao W, Thall PF, et al. Phase II clinical trial of neoadjuvant alternating doublet chemotherapy with ifosfamide/doxorubicin and etoposide/cisplatin in small-cell urothelial cancer. J Clin Oncol. 2009;27(16):2592–7.

    Article  PubMed  CAS  Google Scholar 

  126. Bohle A, Leyh H, Frei C, Kuhn M, Tschada R, Pottek T, et al. Single postoperative instillation of gemcitabine in patients with non-muscle-invasive transitional cell carcinoma of the bladder: a randomised, double-blind, placebo-controlled phase III multicentre study. Eur Urol. 2009;56(3):495–503.

    Article  PubMed  CAS  Google Scholar 

  127. Lamm DL, Riggs DR, Traynelis CL, Nseyo UO. Apparent failure of current intravesical chemotherapy prophylaxis to influence the long-term course of superficial transitional cell carcinoma of the bladder. J Urol. 1995;153(5):1444–50.

    Article  PubMed  CAS  Google Scholar 

  128. O’Donnell MA. Practical applications of intravesical chemotherapy and immunotherapy in high-risk patients with superficial bladder cancer. Urol Clin North Am. 2005;32(2):121–31.

    Article  PubMed  Google Scholar 

  129. Portillo J, Martin B, Hernandez R, Correas M, Gutierrez J, Del Valle J, et al. Results at 43 months’ follow-up of a double-blind, randomized, prospective clinical trial using intravesical interferon alpha-2b in the prophylaxis of stage pT1 transitional cell carcinoma of the bladder. Urology. 1997;49(2):187–90.

    Article  PubMed  CAS  Google Scholar 

  130. Sylvester RJ, Oosterlinck W, van der Meijden AP. A single immediate postoperative instillation of chemotherapy decreases the risk of recurrence in patients with stage Ta T1 bladder cancer: a meta-analysis of published results of randomized clinical trials. J Urol. 2004;171(6 Pt 1):2186–90, quiz 435.

    Google Scholar 

  131. Bohle A, Jocham D, Bock PR. Intravesical bacillus Calmette-Guerin versus mitomycin C for superficial bladder cancer: a formal meta-analysis of comparative studies on recurrence and toxicity. J Urol. 2003;169(1):90–5.

    Article  PubMed  CAS  Google Scholar 

  132. Coplen DE, Marcus MD, Myers JA, Ratliff TL, Catalona WJ. Long-term followup of patients treated with 1 or 2, 6-week courses of intravesical bacillus Calmette-Guerin: analysis of possible predictors of response free of tumor. J Urol. 1990;144(3):652–7.

    PubMed  CAS  Google Scholar 

  133. Hudson MA, Herr HW. Carcinoma in situ of the bladder. J Urol. 1995;153(3 Pt 1):564–72.

    PubMed  CAS  Google Scholar 

  134. Herr HW, Wartinger DD, Fair WR, Oettgen HF. Bacillus Calmette-Guerin therapy for superficial bladder cancer: a 10-year followup. J Urol. 1992;147(4):1020–3.

    PubMed  CAS  Google Scholar 

  135. Han RF, Pan JG. Can intravesical bacillus Calmette-Guerin reduce recurrence in patients with superficial bladder cancer? A meta-analysis of randomized trials. Urology. 2006;67(6):1216–23.

    Article  PubMed  Google Scholar 

  136. Lamm DL, Blumenstein BA, Crissman JD, Montie JE, Gottesman JE, Lowe BA, et al. Maintenance bacillus Calmette-Guerin immunotherapy for recurrent TA, T1 and carcinoma in situ transitional cell carcinoma of the bladder: a randomized Southwest Oncology Group Study. J Urol. 2000;163(4):1124–9.

    Article  PubMed  CAS  Google Scholar 

  137. Bohle A, Bock PR. Intravesical bacille Calmette-Guerin versus mitomycin C in superficial bladder cancer: formal meta-analysis of comparative studies on tumor progression. Urology. 2004;63(4):682–6; discussion 6–7.

    Google Scholar 

  138. Belldegrun AS, Franklin JR, O’Donnell MA, Gomella LG, Klein E, Neri R, et al. Superficial bladder cancer: the role of interferon-alpha. J Urol. 1998;159(6):1793–801.

    Article  PubMed  CAS  Google Scholar 

  139. Joudi FN, Smith BJ, O’Donnell MA. Final results from a national multicenter phase II trial of combination bacillus Calmette-Guerin plus interferon alpha-2B for reducing recurrence of superficial bladder cancer. Urol Oncol. 2006;24(4):344–8.

    Google Scholar 

  140. Lamm DL. Bacillus Calmette-Guerin immunotherapy of superficial bladder cancer. Nippon Hinyokika Gakkai Zasshi. 1995;86(1):9–10.

    PubMed  CAS  Google Scholar 

  141. Lamm DL. Efficacy and safety of bacille Calmette-Guerin immunotherapy in superficial bladder cancer. Clin Infect Dis. 2000;31 Suppl 3:S86–90.

    Article  PubMed  Google Scholar 

  142. Lamm DL, Blumenstein BA, David Crawford E, Crissman JD, Lowe BA, Smith JA, et al. Randomized intergroup comparison of bacillus calmette-guerin immunotherapy and mitomycin C chemotherapy prophylaxis in superficial transitional cell carcinoma of the bladder a southwest oncology group study. Urol Oncol. 1995;1(3):119–26.

    Article  PubMed  CAS  Google Scholar 

  143. van der Meijden AP, Sylvester RJ, Oosterlinck W, Hoeltl W, Bono AV, EG-UTC.Group. Maintenance Bacillus Calmette-Guerin for Ta T1 bladder tumors is not associated with increased toxicity: results from a European Organisation for Research and Treatment of Cancer Genito-Urinary Group Phase III Trial. Eur Urol. 2003;44(4):429–34.

    Article  PubMed  Google Scholar 

  144. Martínez-Piñeiro JA, Flores N, Isorna S, Solsona E, Sebastián JL, Pertusa C, et al. Long-term follow-up of a randomized prospective trial comparing a standard 81 mg dose of intravesical bacille Calmette-Guérin with a reduced dose of 27 mg in superficial bladder cancer. BJU Int. 2002;89(7):671–80.

    Article  PubMed  Google Scholar 

  145. Ojea A, Nogueira JL, Solsona E, Flores N, Gómez JMF, Molina JR, et al. A multicentre, randomised prospective trial comparing three intravesical adjuvant therapies for intermediate-risk superficial bladder cancer: low-dose bacillus Calmette-Guerin (27 mg) versus very low-dose bacillus Calmette-Guerin (13.5 mg) versus mitomycin C. Eur Urol. 2007;52(5):1398–406.

    Article  PubMed  CAS  Google Scholar 

  146. Bassi P, Spinadin R, Carando R, Balta G, Pagano F. Modified induction course: a solution to side-effects? Eur Urol. 2000;37 Suppl 1:31–2.

    Article  PubMed  Google Scholar 

  147. Shelley MD, Wilt TJ, Court J, Coles B, Kynaston H, Mason MD. Intravesical bacillus Calmette-Guerin is superior to mitomycin C in reducing tumour recurrence in high-risk superficial bladder cancer: a meta-analysis of randomized trials. BJU Int. 2004;93(4):485–90.

    Article  PubMed  CAS  Google Scholar 

  148. Sylvester RJ, van der Meijden AP, Witjes JA, Kurth K. Bacillus calmette-guerin versus chemotherapy for the intravesical treatment of patients with carcinoma in situ of the bladder: a meta-analysis of the published results of randomized clinical trials. J Urol. 2005;174(1):86–91; discussion−2.

    Google Scholar 

  149. Sylvester RJ, van der Meijden AP, Oosterlinck W, Witjes JA, Bouffioux C, Denis L, et al. Predicting recurrence and progression in individual patients with stage Ta T1 bladder cancer using EORTC risk tables: a combined analysis of 2596 patients from seven EORTC trials. Eur Urol. 2006;49(3):466–5; discussion 75–7.

    Google Scholar 

  150. Huang GJ, Hamilton AS, Lo M, Stein JP, Penson DF. Predictors of intravesical therapy for non-muscle invasive bladder cancer: results from the surveillance, epidemiology and end results program 2003 patterns of care project. J Urol. 2008;180(2):520–4; discussion 4.

    Google Scholar 

  151. Babjuk M, Oosterlinck W, Sylvester R, Kaasinen E, Bohle A, Palou-Redorta J. EAU guidelines on ­non-muscle-invasive urothelial carcinoma of the bladder. Eur Urol. 2008;54(2):303–14.

    Article  PubMed  Google Scholar 

  152. Thompson Jr RA, Campbell Jr EW, Kramer HC, Jacobs SC, Naslund MJ. Late invasive recurrence despite long-term surveillance for superficial bladder cancer. J Urol. 1993;149(5):1010–1.

    PubMed  Google Scholar 

  153. Holmang S, Johansson SL. Stage Ta-T1 bladder cancer: the relationship between findings at first followup cystoscopy and subsequent recurrence and progression. J Urol. 2002;167(4):1634–7.

    Article  PubMed  Google Scholar 

  154. Holmang S, Hedelin H, Anderstrom C, Johansson SL. The relationship among multiple recurrences, progression and prognosis of patients with stages Ta and T1 transitional cell cancer of the bladder followed for at least 20 years. J Urol. 1995;153(6):1823–6; discussion 6–7.

    Google Scholar 

  155. Soloway MS, Bruck DS, Kim SS. Expectant management of small, recurrent, noninvasive papillary bladder tumors. J Urol. 2003;170(2 Pt 1):438–41.

    Article  PubMed  Google Scholar 

  156. Donat SM, North A, Dalbagni G, Herr HW. Efficacy of office fulguration for recurrent low grade papillary bladder tumors less than 0.5 cm. J Urol. 2004;171(2 Pt 1):636–9.

    Google Scholar 

  157. Herr HW, Dalbagni G. Defining bacillus Calmette-Guerin refractory superficial bladder tumors. J Urol. 2003;169(5):1706–8.

    Article  PubMed  CAS  Google Scholar 

  158. Witjes JA. Management of BCG failures in superficial bladder cancer: a review. Eur Urol. 2006;49(5):790–7.

    Article  PubMed  Google Scholar 

  159. Malmstrom PU, Wijkstrom H, Lundholm C, Wester K, Busch C, Norlen BJ. 5-year followup of a randomized prospective study comparing mitomycin C and bacillus Calmette-Guerin in patients with superficial bladder carcinoma. Swedish-Norwegian Bladder Cancer Study Group. J Urol. 1999;161(4):1124–7.

    Article  PubMed  CAS  Google Scholar 

  160. Steinberg G, Bahnson R, Brosman S, Middleton R, Wajsman Z, Wehle M. Efficacy and safety of valrubicin for the treatment of Bacillus Calmette-Guerin refractory carcinoma in situ of the bladder. The Valrubicin Study Group. J Urol. 2000;163(3):761–7.

    Article  PubMed  CAS  Google Scholar 

  161. O’Donnell MA, Boehle A. Treatment options for BCG failures. World J Urol. 2006;24(5):481–7.

    Article  PubMed  Google Scholar 

  162. Dalbagni G, Russo P, Bochner B, Ben-Porat L, Sheinfeld J, Sogani P, et al. Phase II trial of intravesical gemcitabine in bacille Calmette-Guerin-refractory transitional cell carcinoma of the bladder. J Clin Oncol. 2006;24(18):2729–34.

    Article  PubMed  CAS  Google Scholar 

  163. Davis JW, Sheth SI, Doviak MJ, Schellhammer PF. Superficial bladder carcinoma treated with bacillus Calmette-Guerin: progression-free and disease specific survival with minimum 10-year followup. J Urol. 2002;167(2 Pt 1):494–500; discussion 1.

    Google Scholar 

  164. Herr HW. Timing of cystectomy for superficial bladder tumors. Urol Oncol. 2000;5(4):162–5.

    Article  PubMed  Google Scholar 

  165. Herr HW, Sogani PC. Does early cystectomy improve the survival of patients with high risk superficial bladder tumors? J Urol. 2001;166(4):1296–9.

    Article  PubMed  CAS  Google Scholar 

  166. Huguet J, Crego M, Sabate S, Salvador J, Palou J, Villavicencio H. Cystectomy in patients with high risk superficial bladder tumors who fail intravesical BCG therapy: pre-cystectomy prostate involvement as a prognostic factor. Eur Urol. 2005;48(1):53–9; discussion 9.

    Google Scholar 

  167. Cookson MS, Herr HW, Zhang ZF, Soloway S, Sogani PC, Fair WR. The treated natural history of high risk superficial bladder cancer: 15-year outcome. J Urol. 1997;158(1):62–7.

    Article  PubMed  CAS  Google Scholar 

  168. Leblanc B, Duclos AJ, Benard F, Cote J, Valiquette L, Paquin JM, et al. Long-term followup of initial Ta grade 1 transitional cell carcinoma of the bladder. J Urol. 1999;162(6):1946–50.

    Article  PubMed  CAS  Google Scholar 

  169. Cheng L, Neumann RM, Bostwick DG. Papillary urothelial neoplasms of low malignant potential. Clinical and biologic implications. Cancer. 1999;86(10):2102–8.

    Article  PubMed  CAS  Google Scholar 

  170. Koss LG. Bladder cancer from a perspective of 40 years. J Cell Biochem Suppl. 1992;16I:23–9.

    Article  PubMed  CAS  Google Scholar 

  171. Dreicer R, Li H, Stein M, DiPaola R, Eleff M, Roth BJ, et al. Phase 2 trial of sorafenib in patients with advanced urothelial cancer: a trial of the Eastern Cooperative Oncology Group. Cancer. 2009;115(18):4090–5.

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Cheryl T. Lee .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2012 Springer Science+Business Media New York

About this chapter

Cite this chapter

Jackson, R., Al-Ahmadie, H., Reuter, V.E., Lee, C.T. (2012). Non-Muscle-Invasive Low- and High-Grade Neoplasia. In: Hansel, D., McKenney, J., Stephenson, A., Chang, S. (eds) The Urinary Tract. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-5320-8_6

Download citation

  • DOI: https://doi.org/10.1007/978-1-4614-5320-8_6

  • Published:

  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-1-4614-5319-2

  • Online ISBN: 978-1-4614-5320-8

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics