[837] Measuring Dimension of Tumor Invasion of Urothelial Carcinoma (UCa) in Transurethral Resection Predicts Time of Recurrence.

Zhihong Hu, Gladell P Paner, Kumaran Mudaliar, Guliz A Barkan. Loyola University, Maywood, IL; University of Chicago Hospital, IL

Background: Over time, there have been improvements in diagnosis and treatment of UCa of the bladder by transurethral resection of bladder tumor (TURBT). However, recurrence rate still remains significantly high and thus, additional predictive variables in TURBT specimens are necessary to further enhance patient's management.
Design: A total of 110 TURBT specimens (1997-2005) of UCa were reviewed by 2 genitourinary pathologists. Amount of tumor invasion by UCa was measured in terms of percentage, focality (focal vs. non-focal), and dimension (DI, aggregate length of invasion). Correlating amount of tumor invasion to recurrence was quantified using SAS and Origin.
Results: A total of 39/110 (35%) patients with invasive UCa [9 females (23%), 39 males (77%)], were identified. Patient age ranged from 56 to 94 years old (mean 70 years). Recurrence rate in these patients was 96% (22 of 23); 1 patient had no recurrence (1 of 23). 95% of recurrence (21 of 22) occurred in less than 1 year post TURBT.

Table-1 The Characteristics of Invasive Urothelial Carcinoma
Dimension of tumor invasion (% of all recurrences)<0.1 cm (14%)0.1-0.5 cm (45%)>0.5cm (41%)
The time for recurrence (% of all recurrences)<4 months (32%)4-6 months (23%)>6 months (27%)

UCa with large DI ( ≥0.5 cm) had recurrence in less than 6 months. Conversely, tumor recurrence that occured more than 6 months had smaller DI (< 0.3 cm).

Statistical analysis showed that there was negative correlation of DI with time to recurrence (p<0.05, correlation coefficient: -0.47). Percentage or focality of invasion did not show similar correlation observed in DI.
Conclusions: There is a high correlation between DI and time to recurrence of UCa. Our study indicates that UCa with DI of ≥0.5 cm is likely to recur in less than 6 months and UCa with DI ≤0.3 cm may recur after 6 months. Thus, dimension of tumor invasion as a predictive variable could be considered as a possible variable in surgical pathology reporting of TURBT for UCa.
Category: Genitourinary (including renal tumors)

Tuesday, March 1, 2011 9:30 AM

Poster Session III # 200, Tuesday Morning


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