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01-02-2018 | Original Article

Accuracy and prognostic value of variant histology and lymphovascular invasion at transurethral resection of bladder

Authors: Mohammad Abufaraj, Shahrokh F. Shariat, Beat Foerster, Carmen Pozo, Marco Moschini, David D’Andrea, Romain Mathieu, Martin Susani, Anna K. Czech, Pierre I. Karakiewicz, Veronika Seebacher

Published in: World Journal of Urology | Issue 2/2018

Abstract

Objectives

To evaluate the concordance rate of lymphovascular invasion (LVI) and variant histology (VH) of transurethral resection (TUR) with radical cystectomy (RC) specimens. Furthermore, to evaluate the value of LVI and VH at TUR for predicting non-organ confined (NOC) disease, lymph node metastasis, and survival outcomes.

Patients and methods

Two hundred and sixty-eight patients who underwent TUR and subsequent RC were reviewed. Logistic regression analyses were performed to evaluate the association of LVI and VH with NOC and lymph node metastasis at RC. Cox regression analyses were used to estimate recurrence-free survival (RFS) and cancer-specific survival (CSS).

Results

LVI and VH were detected in 13.8 and 11.2% of TUR specimens, and in 30.2 and 25.4% of RC specimens, respectively. The concordance rate between LVI and VH at TUR and subsequent RC was 69.8 and 83.6%, respectively. They were both associated with adverse pathological features such as lymph node metastasis and advanced stage. TUR LVI and VH were both independently associated with lymph node metastasis and TUR VH was independently associated with NOC. On univariable Cox regression analyses, TUR LVI was associated with RFS and CSS while TUR VH was only associated with RFS. Only TUR LVI was independently associated with RFS.

Conclusion

Detection of LVI is missed in a third of TUR specimens while VH seems more accurately identified. TUR LVI and VH are associated with more advanced disease and LVI predicts disease recurrence. Assessment and reporting of LVI and VH on TUR specimen are important for risk stratification and decision-making.

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Title: Accuracy and prognostic value of variant histology and lymphovascular invasion at transurethral resection of bladder
Authors: Mohammad Abufaraj
Shahrokh F. Shariat
Beat Foerster
Carmen Pozo
Marco Moschini
David D’Andrea
Romain Mathieu
Martin Susani
Anna K. Czech
Pierre I. Karakiewicz
Veronika Seebacher
Publication date: 01-02-2018
Publisher: Springer Berlin Heidelberg
Published in: World Journal of Urology / Issue 2/2018
Print ISSN: 0724-4983
Electronic ISSN: 1433-8726
DOI: https://doi.org/10.1007/s00345-017-2116-3

At a glance: The STEP trials

Springer Medicine

Accuracy and prognostic value of variant histology and lymphovascular invasion at transurethral resection of bladder

Abstract

Objectives

Patients and methods

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Objectives

Patients and methods

Results

Conclusion

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