Long-Term Clinical Outcome in Urothelial Papillomas of the Urinary Bladder.
Ali Amin, Shiela F Faraj, Alcides Chaux, Turki Al-hussain, Roni Cox, Michael Nagar, George J Netto. The Johns Hopkins Hospital, Baltimore
Background: Urothelial Papilloma (UP) is a benign neoplasm of the genitourinary tract. A need for long-term follow up in UP patients is questioned due to its benign biologic behaviour. This is the largest series to date evaluating clinical outcome of UP.
Design: We retrospectively retrieved all cases with a diagnosis of UP from our surgical pathology archives for the period between 1998-2009. All cases with a history of a higher grade urothelial lesion prior to the diagnosis of UP were excluded. Fifty three 'primary" UP cases were thus found forming the current study cohort. Electronic medical records were retrospectively reviewed in all cases. On follow up, recurrence was defined as the development of any subsequent neoplastic lesion of the bladder while progression was defined as the development of any subsequent neoplastic lesion of higher histologic grade or stage.
Results: Follow up was available in 40 cases while the remaining patients were lost to follow up. Mean patient age was 67.4 yrs (median 67.5, range 24–90). The follow-up length ranged from 1–60 mo (mean 16.6, median 12). Recurrence was identified in 19 cases (35%) after a mean duration of 12.7 mo (median 9, range 1–39) from initial UP diagnosis. Seventeen of nineteen (32%) recurrences were associated with progression to a higher grade non invasive urothelial lesion while the remainder 2 recurrent lesions were UP. None of the patients developed invasive urothelial carcinoma. Most frequent progression was to low grade urothelial carcinoma in 7 cases (13%) followed by high grade urothelial carcinoma (4 cases, 7%), urothelial dysplasia and PUNLMP (3 cases each, 5%). None of the 53 patients died of urothelial carcinoma while seven patients died from unrelated causes.
Conclusions: Although none of our patients developed invasive urothelial carcinoma or died of urothelial carcinoma, we found a relatively high rate of recurrence and progression in our UP cohort compared to previous studies.
Category: Genitourinary (including renal tumors)
Tuesday, March 1, 2011 9:15 AM
Platform Session: Section A, Tuesday Morning