Skip to main content
SpringerLink
Log in

Pathology and Staging

  • Chapter
  • First Online:
A Guide to Management of Urological Cancers

Abstract

Urinary bladder carcinoma accounts for approximately 3% of the cancers worldwide and is the fourth most common cancer in men [1, 2]. In the United States, in the year 2021, the estimated number of new cases and the estimated deaths attributed to this cancer were 83,730 and 17,200, respectively [1]. The incidence of bladder cancers is increasing, more so in developed countries. The incidence of new bladder cases in India was 25,873 in the year 2020 and is projected to rise to 29,308 in 2025, as per the National Cancer Registry Programme [3]. Also, the incidence is markedly common in males and older age groups [4]. The most common histology is urothelial carcinoma (UC), seen in more than 90% of cases, while the remaining comprises of squamous cell carcinoma, adenocarcinoma, small cell carcinoma, etc. Bladder cancer is a heterogeneous disease, thus translating into multimodal treatment approaches [4, 5].

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

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 129.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
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. Siegel RL, Miller KD, Fuchs HE, Jemal A. Cancer statistics, 2021. CA Cancer J Clin. 2021;71:7–33.

    Article  PubMed  Google Scholar 

  2. Saginala K, Barsouk A, Aluru JS, Rawla P, Padala SA, Barsouk A. Epidemiology of bladder cancer. Med Sci (Basel). 2020;8:15.

    CAS  PubMed  Google Scholar 

  3. Indian Council of Medical Research. Projection of cancer cases in India. New Delhi: Indian Council of Medical Research; 2020.

    Google Scholar 

  4. Grignon DJAF, Epstein J. Urothelial tumours. In: Holger M, Humphrey PA, Ulbright TM, Reuter VE, editors. Tumours of the urinary tract. 4th ed. Lyon: IARC; 2016.

    Google Scholar 

  5. Flaig TW, Spiess PE, Agarwal N, Bangs R, Boorjian SA, Buyyounouski MK, et al. Bladder cancer, version 3.2020, NCCN clinical practice guidelines in oncology. J Natl Compr Canc Netw. 2020;18:329–54.

    Article  PubMed  Google Scholar 

  6. Freedman ND, Silverman DT, Hollenbeck AR, Schatzkin A, Abnet CC. Association between smoking and risk of bladder cancer among men and women. JAMA. 2011;306:737–45.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  7. Golka K, Wiese A, Assennato G, Bolt HM. Occupational exposure and urological cancer. World J Urol. 2004;21:382–91.

    Article  CAS  PubMed  Google Scholar 

  8. Shih C-J, Chen Y-T, Ou S-M, Yang W-C, Chen T-J, Tarng D-C. Urinary calculi and risk of cancer: a nationwide population-based study. Medicine (Baltimore). 2014;93:e342.

    Article  PubMed  Google Scholar 

  9. Jones TD, Wang M, Eble JN, MacLennan GT, Lopez-Beltran A, Zhang S, et al. Molecular evidence supporting field effect in urothelial carcinogenesis. Clin Cancer Res. 2005;11:6512–9.

    Article  CAS  PubMed  Google Scholar 

  10. Cheng L, Davidson DD, Maclennan GT, Williamson SR, Zhang S, Koch MO, et al. The origins of urothelial carcinoma. Expert Rev Anticancer Ther. 2010;10:865–80.

    Article  CAS  PubMed  Google Scholar 

  11. Cheng L, Zhang S, MacLennan GT, Williamson SR, Lopez-Beltran A, Montironi R. Bladder cancer: translating molecular genetic insights into clinical practice. Hum Pathol. 2011;42:455–81.

    Article  CAS  PubMed  Google Scholar 

  12. Koss LG, Tiamson EM, Robbins MA. Mapping cancerous and precancerous bladder changes. A study of the urothelium in ten surgically removed bladders. JAMA. 1974;227:281–6.

    Article  CAS  PubMed  Google Scholar 

  13. Sidransky D, Frost P, Von Eschenbach A, Oyasu R, Preisinger AC, Vogelstein B. Clonal origin of bladder cancer. N Engl J Med. 1992;326:737–40.

    Article  CAS  PubMed  Google Scholar 

  14. Habuchi T, Takahashi R, Yamada H, Kakehi Y, Sugiyama T, Yoshida O. Metachronous multifocal development of urothelial cancers by intraluminal seeding. Lancet. 1993;342:1087–8.

    Article  CAS  PubMed  Google Scholar 

  15. Takahashi T, Habuchi T, Kakehi Y, Mitsumori K, Akao T, Terachi T, et al. Clonal and chronological genetic analysis of multifocal cancers of the bladder and upper urinary tract. Cancer Res. 1998;58:5835–41.

    CAS  PubMed  Google Scholar 

  16. Fadl-Elmula I, Gorunova L, Mandahl N, Elfving P, Lundgren R, Mitelman F, et al. Cytogenetic monoclonality in multifocal uroepithelial carcinomas: evidence of intraluminal tumour seeding. Br J Cancer. 1999;81:6–12.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  17. Mostofi FK. Histological typing of urinary bladder tumors, International histological classification of tumors, vol. 17. Geneva: WHO; 1973.

    Google Scholar 

  18. Otto W, Denzinger S, Fritsche HM, Burger M, Wieland WF, Hofstädter F, et al. The WHO classification of 1973 is more suitable than the WHO classification of 2004 for predicting survival in pT1 urothelial bladder cancer. BJU Int. 2011;107:404–8.

    Article  PubMed  Google Scholar 

  19. Chen Z, Ding W, Xu K, Tan J, Sun C, Gou Y, et al. The 1973 WHO classification is more suitable than the 2004 WHO classification for predicting prognosis in non-muscle-invasive bladder cancer. PLoS One. 2012;7:e47199.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  20. Compérat E, Burger M, Gontero P, Mostafid AH, Palou J, Rouprêt M, et al. Grading of urothelial carcinoma and the new “World Health Organisation classification of tumours of the urinary system and male genital organs 2016”. Eur Urol Focus. 2019;5:457–66.

    Article  PubMed  Google Scholar 

  21. Soukup V, Čapoun O, Cohen D, Hernández V, Babjuk M, Burger M, et al. Prognostic performance and reproducibility of the 1973 and 2004/2016 World Health Organization grading classification Systems in non-muscle-invasive Bladder Cancer: a European Association of Urology non-muscle invasive bladder cancer guidelines panel systematic review. Eur Urol. 2017;72:801–13.

    Article  PubMed  Google Scholar 

  22. Bosschieter J, Hentschel A, Savci-Heijink CD, Patrick van der Voorn J, Rozendaal L, Vis AN, et al. Reproducibility and prognostic performance of the 1973 and 2004 World Health Organization classifications for grade in non-muscle-invasive bladder cancer: a multicenter study in 328 bladder tumors. Clin Genitourin Cancer. 2018;16:e985–e92.

    Article  PubMed  Google Scholar 

  23. Pauwels RP, Schapers RF, Smeets AW, Debruyne FM, Geraedts JP. Grading in superficial bladder cancer. (1). Morphological criteria. Br J Urol. 1988;61:129–34.

    Article  CAS  PubMed  Google Scholar 

  24. Epstein JI, Amin MB, Reuter VR, Mostofi FK, Committee TBCC. The World Health Organization/International Society of Urological Pathology Consensus Classification of Urothelial (transitional cell) neoplasms of the urinary bladder. Am J Surg Pathol. 1998;22:1435–48.

    Article  CAS  PubMed  Google Scholar 

  25. Humphrey PA, Moch H, Cubilla AL, Ulbright TM, Reuter VE. The 2016 WHO classification of tumours of the urinary system and male genital organs-part B: prostate and bladder tumours. Eur Urol. 2016;70:106–19.

    Article  PubMed  Google Scholar 

  26. Roehrborn CG, Sagalowsky AI, Peters PC. Long-term patient survival after cystectomy for regional metastatic transitional cell carcinoma of the bladder. J Urol. 1991;146:36–9.

    Article  CAS  PubMed  Google Scholar 

  27. Pollack A, Zagars GK, Cole CJ, Dinney CP, Swanson DA, Grossman HB. The relationship of local control to distant metastasis in muscle invasive bladder cancer. J Urol. 1995;154:2059–64.

    Article  CAS  PubMed  Google Scholar 

  28. Lopez-Beltran A, Cheng L. Histologic variants of urothelial carcinoma: differential diagnosis and clinical implications. Hum Pathol. 2006;37:1371–88.

    Article  CAS  PubMed  Google Scholar 

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

    CAS  PubMed  Google Scholar 

  30. Lopez Beltran A, Montironi R, Cheng L. Microcystic urothelial carcinoma: morphology, immunohistochemistry and clinical behaviour. Histopathology. 2014;64:872–9.

    Article  PubMed  Google Scholar 

  31. Johansson SL, Borghede G, Holmäng S. Micropapillary bladder carcinoma: a clinicopathological study of 20 cases. J Urol. 1999;161:1798–802.

    Article  CAS  PubMed  Google Scholar 

  32. Williamson SR, Zhang S, Lopez-Beltran A, Shah RB, Montironi R, Tan PH, et al. Lymphoepithelioma-like carcinoma of the urinary bladder: clinicopathologic, immunohistochemical, and molecular features. Am J Surg Pathol. 2011;35:474–83.

    Article  PubMed  Google Scholar 

  33. Lopez-Beltran A, Blanca A, Montironi R, Cheng L, Regueiro JC. Pleomorphic giant cell carcinoma of the urinary bladder. Hum Pathol. 2009;40:1461–6.

    Article  CAS  PubMed  Google Scholar 

  34. Lopez-Beltran A, Amin MB, Oliveira PS, Montironi R, Algaba F, McKenney JK, et al. Urothelial carcinoma of the bladder, lipid cell variant: clinicopathologic findings and LOH analysis. Am J Surg Pathol. 2010;34:371–6.

    Article  PubMed  Google Scholar 

  35. Kotliar SN, Wood CG, Schaeffer AJ, Oyasu R. Transitional cell carcinoma exhibiting clear cell features. A differential diagnosis for clear cell adenocarcinoma of the urinary tract. Arch Pathol Lab Med. 1995;119:79–81.

    CAS  PubMed  Google Scholar 

  36. Jordan AM, Weingarten J, Murphy WM. Transitional cell neoplasms of the urinary bladder. Can biologic potential be predicted from histologic grading? Cancer. 1987;60:2766–74.

    Article  CAS  PubMed  Google Scholar 

  37. Holmäng S, Hedelin H, Anderström C, Holmberg E, Busch C, Johansson SL. Recurrence and progression in low grade papillary urothelial tumors. J Urol. 1999;162:702–7.

    Article  PubMed  Google Scholar 

  38. Holmäng 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;165:1124–8.

    Article  PubMed  Google Scholar 

  39. Pan CC, Chang YH, Chen KK, Yu HJ, Sun CH, Ho DM. Prognostic significance of the 2004 WHO/ISUP classification for prediction of recurrence, progression, and cancer-specific mortality of non-muscle-invasive urothelial tumors of the urinary bladder: a clinicopathologic study of 1,515 cases. Am J Clin Pathol. 2010;133:788–95.

    Article  PubMed  Google Scholar 

  40. Maxwell JP, Wang C, Wiebe N, Yilmaz A, Trpkov K. Long-term outcome of primary papillary urothelial neoplasm of low malignant potential (PUNLMP) including PUNLMP with inverted growth. Diagn Pathol. 2015;10:3.

    Article  PubMed  PubMed Central  Google Scholar 

  41. Babjuk M, Böhle A, Burger M, Capoun O, Cohen D, Compérat EM, et al. EAU guidelines on non–muscle-invasive urothelial carcinoma of the bladder: update 2016. Eur Urol. 2017;71:447–61.

    Article  PubMed  Google Scholar 

  42. Collà Ruvolo C, Würnschimmel C, Wenzel M, Nocera L, Califano G, Tian Z, et al. Comparison between 1973 and 2004/2016 WHO grading systems in patients with ta urothelial carcinoma of urinary bladder. J Clin Pathol. 2022;75:333–7.

    Article  PubMed  Google Scholar 

  43. Collà Ruvolo C, Würnschimmel C, Wenzel M, Nocera L, Celentano G, Mangiapia F, et al. Comparison between 1973 and 2004/2016 World Health Organization grading in upper tract urothelial carcinoma treated with radical nephroureterectomy. Int J Clin Oncol. 2021;26:1707–13.

    Article  PubMed  PubMed Central  Google Scholar 

  44. Reis LO, Taheri D, Chaux A, Guner G, Mendoza Rodriguez MA, Bivalacqua TJ, et al. Significance of a minor high-grade component in a low-grade noninvasive papillary urothelial carcinoma of bladder. Hum Pathol. 2016;47:20–5.

    Article  PubMed  Google Scholar 

  45. Amin MB, Comperat E, Epstein JI, True LD, Hansel D, Paner GP, et al. The genitourinary pathology society update on classification and grading of flat and papillary urothelial neoplasia with new reporting recommendations and approach to lesions with mixed and early patterns of neoplasia. Adv Anat Pathol. 2021;28:179–95.

    Article  PubMed  Google Scholar 

  46. Jones PA, Droller MJ. Pathways of development and progression in bladder cancer: new correlations between clinical observations and molecular mechanisms. Semin Urol. 1993;11:177–92.

    CAS  PubMed  Google Scholar 

  47. The Cancer Genome Atlas Research Network. Comprehensive molecular characterization of urothelial bladder carcinoma. Nature. 2014;507:315–22.

    Article  Google Scholar 

  48. Hedegaard J, Lamy P, Nordentoft I, Algaba F, Høyer S, Ulhøi BP, et al. Comprehensive transcriptional analysis of early-stage urothelial carcinoma. Cancer Cell. 2016;30:27–42.

    Article  CAS  PubMed  Google Scholar 

  49. Platt FM, Hurst CD, Taylor CF, Gregory WM, Harnden P, Knowles MA. Spectrum of phosphatidylinositol 3-kinase pathway gene alterations in bladder cancer. Clin Cancer Res. 2009;15:6008–17.

    Article  CAS  PubMed  Google Scholar 

  50. Minoli M, Kiener M, Thalmann GN, Kruithof-de Julio M, Seiler R. Evolution of urothelial bladder cancer in the context of molecular classifications. Int J Mol Sci. 2020;21:5670.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  51. Meeks JJ, Carneiro BA, Pai SG, Oberlin DT, Rademaker A, Fedorchak K, et al. Genomic characterization of high-risk non-muscle invasive bladder cancer. Oncotarget. 2016;7:75176–84.

    Article  PubMed  PubMed Central  Google Scholar 

  52. Kamoun A, de Reyniès A, Allory Y, Sjödahl G, Robertson AG, Seiler R, et al. A consensus molecular classification of muscle-invasive bladder cancer. Eur Urol. 2020;77:420–33.

    Article  PubMed  Google Scholar 

  53. Robertson AG, Kim J, Al-Ahmadie H, Bellmunt J, Guo G, Cherniack AD, et al. Comprehensive molecular characterization of muscle-invasive bladder cancer. Cell. 2017;171:540–56.e25.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  54. Robertson AG, Groeneveld CS, Jordan B, Lin X, McLaughlin KA, Das A, et al. Identification of differential tumor subtypes of T1 bladder cancer. Eur Urol. 2020;78:533–7.

    Article  CAS  PubMed  Google Scholar 

  55. Choi W, Porten S, Kim S, Willis D, Plimack ER, Hoffman-Censits J, et al. Identification of distinct basal and luminal subtypes of muscle-invasive bladder cancer with different sensitivities to frontline chemotherapy. Cancer Cell. 2014;25:152–65.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  56. Rebola J, Aguiar P, Blanca A, Montironi R, Cimadamore A, Cheng L, et al. Predicting outcomes in non-muscle invasive (ta/T1) bladder cancer: the role of molecular grade based on luminal/basal phenotype. Virchows Arch. 2019;475:445–55.

    Article  CAS  PubMed  Google Scholar 

  57. Desai S, Dug Lim S, 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;13:1315–23.

    Article  CAS  PubMed  Google Scholar 

  58. McKenney JK, Amin MB. The role of immunohistochemistry in the diagnosis of urinary bladder neoplasms. Semin Diagn Pathol. 2005;22:69–87.

    Article  PubMed  Google Scholar 

  59. Mallofré C, Castillo M, Morente V, Solé M. Immunohistochemical expression of CK20, p53, and Ki-67 as objective markers of urothelial dysplasia. Mod Pathol. 2003;16:187–91.

    Article  PubMed  Google Scholar 

  60. Compérat E, Camparo P, Haus R, Chartier-Kastler E, Radenen B, Richard F, et al. Aurora-a/STK-15 is a predictive factor for recurrent behaviour in non-invasive bladder carcinoma: a study of 128 cases of non-invasive neoplasms. Virchows Arch. 2007;450:419–24.

    Article  PubMed  Google Scholar 

  61. van Rhijn BWG, Zuiverloon TCM, Vis AN, Radvanyi F, van Leenders GJLH, Ooms BCM, et al. Molecular grade (FGFR3/MIB-1) and EORTC risk scores are predictive in primary non–muscle-invasive bladder cancer. Eur Urol. 2010;58(3):433–41.

    Article  PubMed  Google Scholar 

  62. Burger M, van der Aa MN, van Oers JM, Brinkmann A, van der Kwast TH, Steyerberg EC, et al. Prediction of progression of non-muscle-invasive bladder cancer by WHO 1973 and 2004 grading and by FGFR3 mutation status: a prospective study. Eur Urol. 2008;54:835–43.

    Article  PubMed  Google Scholar 

  63. Missaoui N, Bdioui A, Baccouche A, Belkacem O, Hmida W, Mokni M, et al. Significance of p53, p27, Ki-67, E-cadherin, and HER2 expression in upper urinary tract urothelial carcinoma. J Egypt Natl Canc Inst. 2020;32:36.

    Article  PubMed  Google Scholar 

  64. Petrelli F, Coinu A, Cabiddu M, Ghilardi M, Vavassori I, Barni S. Correlation of pathologic complete response with survival after neoadjuvant chemotherapy in bladder cancer treated with cystectomy: a meta-analysis. Eur Urol. 2014;65:350–7.

    Article  PubMed  Google Scholar 

  65. Lavery HJ, Stensland KD, Niegisch G, Albers P, Droller MJ. Pathological T0 following radical cystectomy with or without neoadjuvant chemotherapy: a useful surrogate. J Urol. 2014;191:898–906.

    Article  PubMed  Google Scholar 

  66. Pokuri VK, Syed JR, Yang Z, Field EP, Cyriac S, Pili R, et al. Predictors of complete pathologic response (pT0) to neoadjuvant chemotherapy in muscle-invasive bladder carcinoma. Clin Genitourin Cancer. 2016;14:e59–65.

    Article  PubMed  Google Scholar 

  67. Kassouf W, Spiess PE, Brown GA, Munsell MF, Grossman HB, Siefker-Radtke A, et al. P0 stage at radical cystectomy for bladder cancer is associated with improved outcome independent of traditional clinical risk factors. Eur Urol. 2007;52:769–74.

    Article  PubMed  PubMed Central  Google Scholar 

  68. MacLennan GT, Kirkali Z, Cheng L. Histologic grading of noninvasive papillary urothelial neoplasms. Eur Urol. 2007;51:889–98.

    Article  PubMed  Google Scholar 

  69. Magers MJ, Lopez-Beltran A, Montironi R, Williamson SR, Kaimakliotis HZ, Cheng L. Staging of bladder cancer. Histopathology. 2019;74:112–34.

    Article  PubMed  Google Scholar 

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

    Article  CAS  PubMed  Google Scholar 

  71. 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;169:1291–4.

    Article  PubMed  Google Scholar 

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

    Article  PubMed  Google Scholar 

  73. Cao D, Vollmer RT, Luly J, Jain S, Roytman TM, Ferris CW, et al. Comparison of 2004 and 1973 World Health Organization grading systems and their relationship to pathologic staging for predicting long-term prognosis in patients with urothelial carcinoma. Urology. 2010;76:593–9.

    Article  PubMed  Google Scholar 

  74. van Rhijn BW, van Leenders GJ, Ooms BC, Kirkels WJ, Zlotta AR, Boevé ER, et al. The pathologist’s mean grade is constant and individualizes the prognostic value of bladder cancer grading. Eur Urol. 2010;57:1052–7.

    Article  PubMed  Google Scholar 

  75. McKenney JK, Gomez JA, Desai S, Lee MW, Amin MB. Morphologic expressions of urothelial carcinoma in situ: a detailed evaluation of its histologic patterns with emphasis on carcinoma in situ with microinvasion. Am J Surg Pathol. 2001;25:356–62.

    Article  CAS  PubMed  Google Scholar 

  76. Beukers W, Meijer T, Vissers CJ, Boormans JL, Zwarthoff EC, van Leenders GJLH. Down-staging (<pT2) of urothelial cancer at cystectomy after the diagnosis of detrusor muscle invasion (pT2) at diagnostic transurethral resection (TUR): is prediction possible? Virchows Arch. 2012;461:149–56.

    Article  PubMed  PubMed Central  Google Scholar 

  77. Fernandez N, Zhai Q. The value of smoothelin to determine invasion depth of urothelial carcinoma by differentiating hyperplastic muscularis mucosa from muscularispropia. Am J Clin Pathol. 2012;138:A342.

    Article  Google Scholar 

  78. Jewett HJ. Carcinoma of the bladder: influence of depth of infiltration on the 5-year results following complete extirpation of the primary growth. J Urol. 1952;67:672–80.

    Article  CAS  PubMed  Google Scholar 

  79. Herr HW. Staging invasive bladder tumors. J Surg Oncol. 1992;51:217–20.

    Article  CAS  PubMed  Google Scholar 

  80. Hall RR, Prout GR. Staging of bladder cancer: is the tumor, node, metastasis system adequate? Semin Oncol. 1990;17:517–23.

    CAS  PubMed  Google Scholar 

  81. Skinner DG. Current state of classification and staging of bladder cancer. Cancer Res. 1977;37:2838–42.

    CAS  PubMed  Google Scholar 

  82. Tokgoz H, Türkölmez K, Resorlu B, Kose K, Tulunay O, Beduk Y. Pathological staging of muscle invasive bladder cancer. Is substaging of pT2 tumors really necessary? Int Braz J Urol. 2007;33:777–83.

    Article  PubMed  Google Scholar 

  83. Boudreaux KJ Jr, Clark PE, Lowrance WT, Rumohr JA, Barocas DA, Cookson MS, et al. Comparison of american joint committee on cancer pathological stage T2a versus T2b urothelial carcinoma: analysis of patient outcomes in organ confined bladder cancer. J Urol. 2009;181:540–6.

    Article  PubMed  Google Scholar 

  84. Tilki D, Reich O, Karakiewicz PI, Novara G, Kassouf W, Ergün S, et al. Validation of the AJCC TNM substaging of pT2 bladder cancer: deep muscle invasion is associated with significantly worse outcome. Eur Urol. 2010;58:112–7.

    Article  PubMed  Google Scholar 

  85. Sonpavde G, Khan MM, Svatek RS, Lee R, Novara G, Tilki D, et al. Prognostic risk stratification of pathological stage T2N0 bladder cancer after radical cystectomy. BJU Int. 2011;108:687–92.

    PubMed  Google Scholar 

  86. Gakis G, Schilling D, Renninger M, Seibold J, Sievert KD, Stenzl A. Comparison of the new American joint Committee on cancer substratification in node-negative pT2 urothelial carcinoma of the bladder: analysis of patient outcomes in a contemporary series. BJU Int. 2011;107:919–23.

    Article  PubMed  Google Scholar 

  87. Quek ML, Stein JP, Clark PE, Daneshmand S, Miranda G, Cai J, et al. Microscopic and gross extravesical extension in pathological staging of bladder cancer. J Urol. 2004;171:640–5.

    Article  PubMed  Google Scholar 

  88. Boudreaux KJ Jr, Chang SS, Lowrance WT, Rumohr JA, Barocas DA, Cookson MS, et al. Comparison of American joint Committee on cancer pathologic stage T3a versus T3b urothelial carcinoma: analysis of patient outcomes. Cancer. 2009;115:770–5.

    Article  PubMed  Google Scholar 

  89. Dincel C, Kara C, Balci U, Ozer K, Ozbir S, Sefik E, et al. Comparison of microscopic (pT3a) and gross extravesical extension (pT3b) in pathological staging of bladder cancer: analysis of patient outcomes. Int Urol Nephrol. 2013;45:387–93.

    Article  PubMed  Google Scholar 

  90. Scosyrev E, Yao J, Messing E. Microscopic invasion of perivesical fat by urothelial carcinoma: implications for prognosis and pathology practice. Urology. 2010;76:908–14.

    Article  PubMed  Google Scholar 

  91. Neuzillet Y, Lebret T, Molinie V, Yonneau L, Herve J-M, Theodore C, et al. Perivesical fat invasion in bladder cancer: implications for prognosis comparing pT2b, pT3a and pT3b stages and consequences for adjuvant chemotherapy indications. BJU Int. 2012;110:1736–41.

    Article  PubMed  Google Scholar 

  92. Bastian PJ, Hutterer GC, Shariat SF, Rogers CG, Palapattu GS, Lotan Y, et al. Macroscopic, but not microscopic, perivesical fat invasion at radical cystectomy is an adverse predictor of recurrence and survival. BJU Int. 2008;101:450–4.

    PubMed  Google Scholar 

  93. Philip AT, Amin MB, Tamboli P, Lee TJ, Hill CE, Ro JY. Intravesical adipose tissue: a quantitative study of its presence and location with implications for therapy and prognosis. Am J Surg Pathol. 2000;24:1286–90.

    Article  CAS  PubMed  Google Scholar 

  94. Tilki D, Svatek RS, Karakiewicz PI, Novara G, Seitz M, Sonpavde G, et al. pT3 substaging is a prognostic indicator for lymph node negative urothelial carcinoma of the bladder. J Urol. 2010;184:470–4.

    Article  PubMed  Google Scholar 

  95. Esrig D, Freeman JA, Elmajian DA, Stein JP, Chen SC, Groshen S, et al. Transitional cell carcinoma involving the prostate with a proposed staging classification for stromal invasion. J Urol. 1996;156:1071–6.

    Article  CAS  PubMed  Google Scholar 

  96. Knoedler JJ, Boorjian SA, Tollefson MK, Cheville JC, Thapa P, Tarrell RF, et al. Urothelial carcinoma involving the prostate: the association of revised tumour stage and coexistent bladder cancer with survival after radical cystectomy. BJU Int. 2014;114:832–6.

    Article  PubMed  Google Scholar 

  97. NjinouNgninkeu B, Lorge F, Moulin P, Jamart J, Van Cangh PJ. Transitional cell carcinoma involving the prostate: a clinicopathological retrospective study of 76 cases. J Urol. 2003;169:149–52.

    Article  CAS  Google Scholar 

  98. Ayyathurai R, Gomez P, Luongo T, Soloway MS, Manoharan M. Prostatic involvement by urothelial carcinoma of the bladder: clinicopathological features and outcome after radical cystectomy. BJU Int. 2007;100:1021–5.

    PubMed  Google Scholar 

  99. Vallo S, Gilfrich C, Burger M, Volkmer B, Boehm K, Rink M, et al. Comparative analysis of the effect of prostatic invasion patterns on cancer-specific mortality after radical cystectomy in pT4a urothelial carcinoma of the bladder. Urol Oncol. 2016;34:432.e1–8.

    Article  PubMed  Google Scholar 

  100. Daneshmand S, Stein JP, Lesser T, Quek ML, Nichols PW, Miranda G, et al. Prognosis of seminal vesicle involvement by transitional cell carcinoma of the bladder. J Urol. 2004;172:81–4.

    Article  PubMed  Google Scholar 

  101. May M, Bastian PJ, Brookman-May S, Fritsche HM, Tilki D, Otto W, et al. Gender-specific differences in cancer-specific survival after radical cystectomy for patients with urothelial carcinoma of the urinary bladder in pathologic tumor stage T4a. Urol Oncol. 2013;31:1141–7.

    Article  PubMed  Google Scholar 

  102. Liberman D, Alasker A, Sun M, Ismail S, Lughezzani G, Jeldres C, et al. Radical cystectomy for patients with pT4 urothelial carcinoma in a large population-based study. BJU Int. 2011;107:905–11.

    Article  PubMed  Google Scholar 

  103. Pedrosa JA, Koch MO, Cheng L. Lymph node-positive bladder cancer: surgical, pathologic, molecular and prognostic aspects. Expert Rev Anticancer Ther. 2013;13:1281–95.

    Article  CAS  PubMed  Google Scholar 

  104. Herr HW, Bochner BH, Dalbagni G, Donat SM, Reuter VE, Bajorin DF. Impact of the number of lymph nodes retrieved on outcome in patients with muscle invasive bladder cancer. J Urol. 2002;167:1295–8.

    Article  PubMed  Google Scholar 

  105. Wright JL, Lin DW, Porter MP. The association between extent of lymphadenectomy and survival among patients with lymph node metastases undergoing radical cystectomy. Cancer. 2008;112:2401–8.

    Article  PubMed  Google Scholar 

  106. Galsky MD, Moshier E, Krege S, Lin CC, Hahn N, Ecke T, et al. Nomogram for predicting survival in patients with unresectable and/or metastatic urothelial cancer who are treated with cisplatin-based chemotherapy. Cancer. 2013;119:3012–9.

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Pathology, Tata Memorial Centre, Mumbai, India

    Gauri Deshpande, Santosh Menon & Sangeeta Desai

Authors
  1. Gauri Deshpande
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Santosh Menon
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Sangeeta Desai
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. Department of Urology, All India Institute of Medical Sciences, New Delhi, Delhi, India

    Prabhjot Singh

  2. Department of Urology, All India Institute of Medical Sciences, New Delhi, Delhi, India

    Brusabhanu Nayak

  3. Department of Urology, All India Institute of Medical Sciences, New Delhi, Delhi, India

    Sridhar Panaiyadiyan

Rights and permissions

Reprints and permissions

Copyright information

© 2023 The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd.

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Deshpande, G., Menon, S., Desai, S. (2023). Pathology and Staging. In: Singh, P., Nayak, B., Panaiyadiyan, S. (eds) A Guide to Management of Urological Cancers. Springer, Singapore. https://doi.org/10.1007/978-981-99-2341-0_10

Download citation

  • DOI: https://doi.org/10.1007/978-981-99-2341-0_10

  • Published:

  • Publisher Name: Springer, Singapore

  • Print ISBN: 978-981-99-2340-3

  • Online ISBN: 978-981-99-2341-0

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation