[839] Effect of New AJCC pT4 Exclusion of Intraurethral Prostatic Stromal Invasion (IPSI) in Bladder Cancer: Stage in Bladder Proper Remains Predictive of Mortality in Non-pT4 Categories with IPSI

Joshua A Cohn, Amit R Patel, Ranko Miocinovic, Jerome B Taxy, Gary D Steinberg, Donna E Hansel, Gladell P Paner. University of Chicago, Chicago, IL; Cleveland Clinic, Cleveland, OH

Background: In 2010, the AJCC reclassified T staging for bladder cancer (BC) to exclude subepithelial or intraurethral prostatic stromal invasion (IPSI) from pT4a, reserving pT4a for tumors extending into prostate by direct invasion through the bladder wall. Recently, our group validated the prognostic difference between the new pT4a vs. <pT2 with IPSI (J Urol 2013). However, the prognostic impact of IPSI particularly in other non-pT4 categories remains unclear.
Design: BC patients with prostatic stromal invasion on RC from the two institutions (12/1994-10/2011 and 3/2004-3/2010) were included. Variant histology and IPSI with extra-prostatic extension were excluded. Patients were divided based on bladder stage into: Results: 145 BC patients that included 97 with IPSI and 48 with transmural prostatic invasion (pT4a) were identified. Of patients with IPSI, 26 (27%) had bladder stage 2 [HR 1.99 (1.09-3.62); p=0.02] and bladder stage (HR 1.38 (1.01-1.89); p=0.041].


Conclusions: Bladder pT stage predicts decreased OS and CSS in BC with IPSI. These findings support that if IPSI is identified, stage should follow the BC pT status in bladder proper. However, it is unclear if the lowest pT categories (Category: Genitourinary (including renal tumors)

Tuesday, March 5, 2013 1:45 PM

Proffered Papers: Section A, Tuesday Afternoon

 

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