Bladder Cancer Sample Handling and Reporting: Pathologist's Point of View

Mazzucchelli, Roberta; Marzioni, Daniela; Tossetta, Giovanni; Pepi, Laura; Montironi, Rodolfo

doi:10.3389/fsurg.2021.754741

Cited by 7 publications

(5 citation statements)

References 89 publications

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“…The bladder cold cup biopsies are usually 2–3 mm in diameter and can contain up to superficial parts of muscularis propria depending on anatomical part of the urinary bladder and the operator skill 22 . However Invasive urothelial carcinoma may present (cystoscopically and grossly) as a polypoid, sessile, ulcerated fungating and/or infiltrative lesion 23 , 24 , Histopathological examination still the cornerstone in reaching out the most accurate diagnosis 22 , 25 . Different histological tumour types were reported according to the 2016 WHO 26 , urinary bladder tumours classification by the authors histopathologists the correlated with the radiological features.…”

Section: Discussionmentioning

confidence: 99%

Recent advances in three-dimensional ultrasound virtual cystoscopy in modeling and local staging for urothelial carcinoma with histopathological correlation: a cohort prospective study

Mohamed,

Aly,

Badran

et al. 2023

Annals of Medicine &Amp; Surgery

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Background: Bladder urothelial carcinoma is an alarming urologic malignancy. Complex factors like modeling and local staging can affect treatment strategy. However, local staging, particularly the muscle invasion status, significantly influences decisions regarding treatment strategies. Therefore, this study aims to evaluate the novel advances of three-dimensional ultrasound imaging to assess local staging in comparison with conventional cystoscopy. Methods: Forty-three patients with painless hematuria and conventional cystoscopy findings of bladder mass underwent three-dimensional ultrasound virtual cystoscopy. All specimens from conventional cystoscopy were processed histologically. Results: Out of 43 participants, 18 (41.9%) patients proved to have invasive urothelial carcinoma by histopathology. The three-dimensional US had a sensitivity of 97.5% and a specificity of 100%, however conventional cystoscopy was accurate in only 53.5% of the studied cases. Furthermore, in the case of malignant ulcers, mural extension into both the submucosal and the muscle layers was more readily appreciated in multiplanar images. Conclusion: Three-dimensional ultrasound updates are promising for use in bladder tumor modeling and local staging; however, they can be of value in evaluating mural and extramural tumor extent and have proven accuracy.

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Section: Discussionmentioning

confidence: 99%

Recent advances in three-dimensional ultrasound virtual cystoscopy in modeling and local staging for urothelial carcinoma with histopathological correlation: a cohort prospective study

Mohamed,

Aly,

Badran

et al. 2023

Annals of Medicine &Amp; Surgery

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“…According to the International Collaboration on Cancer Reporting guidelines, apart from the pathological stage and histological grade, the pathological report of BCa specimens obtained by biopsy or transurethral resection should include the status of muscularis propria, histological variation, LVI and T1 substaging ( 44 ). Therefore, for the tumor specimens collected after ERBT, pathologists should focus on pathological stage, histological variation, LVI and related auxiliary techniques, such as immunohistochemistry, to evaluate these characteristics ( 45 , 46 ). Meanwhile, the whole specimen section should be considered in the histopathological analysis to determine the status of the tumor margins ( 47 ).…”

Section: Cooperate With Pathologist To Make Accurate Histopathologica...mentioning

confidence: 99%

Precise diagnosis and treatment of non-muscle invasive bladder cancer - A clinical perspective

Yang

Wang

et al. 2023

Front. Oncol.

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According to the guidelines, transurethral resection of bladder tumor (TURBT) followed by intravesical therapy remains the standard strategy for the management of non-muscle invasive bladder cancer (NMIBC). However, even if patients receive standard strategy, the risk of postoperative recurrence and progression is high. From the clinical perspective, the standard strategy needs to be optimized and improved. Compared to conventional TURBT, the technique of en bloc resection of bladder tumor (ERBT) removes the tumor tissue in one piece, thus following the principles of cancer surgery. Meanwhile, the integrity and spatial orientation of tumor tissue is protected during the operation, which is helpful for pathologists to make accurate histopathological analysis. Then, urologists can make a postoperative individualized treatment plan based on the patient’s clinical characteristics and histopathological results. To date, there is no strong evidence that NMIBC patients treated with ERBT achieve better oncological prognosis, which indicates that ERBT alone does not yet improve patient outcomes. With the development of enhanced imaging technology and proteogenomics technology, en bloc resection combined with these technologies will make it possible to achieve precise diagnosis and treatment of bladder cancer. In this review, the authors analyze the current existing shortcomings of en bloc resection and points out its future direction, in order to promote continuous optimization of the management strategy of bladder cancer.

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“…Micropapillary urothelial carcinoma has been described, morphologically, as tumor cells arranged in multiple small nests without fibrovascular cores aggregating within lacunae (43). The presence of multiple small nests within the same lacunar space is characteristic.…”

Section: Micropapillarymentioning

confidence: 99%

Overview of histologic variants of urothelial carcinoma: current trends and narrative review on treatment outcomes

Ogbue

Haddad²,

Almassi³

et al. 2022

Transl Androl Urol

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Background and Objective: The histologic variants of urothelial carcinoma (UC) are tumors arising from within the urothelium in which some component of the tumor morphology is other than urothelial.They are underdiagnosed, aggressive and have varying pathologic response rates to systemic chemotherapy.There are no consensus guidelines on the use of systemic chemotherapy in variant histology (VH) of UC. We performed a contemporary review on pathologic response rates to neoadjuvant systemic therapy and survival outcomes following radical cystectomy in order to provide a rationale for clinical practice recommendations on the management of UC with VH.Methods: A PubMed literature search was conducted for all English articles from inception reporting either pathological response rates to neoadjuvant treatment or survival outcomes after radical cystectomy in non-metastatic VH of UC.Key Content and Findings: Neoadjuvant chemotherapy (NAC) prior to radical cystectomy was shown to be a beneficial treatment strategy in UC with VH. The micropapillary, plasmacytoid, nested and sarcomatoid histologic variants were associated with worse survival outcomes compared to conventional UC and UC with squamous or glandular differentiation despite initial downstaging with chemotherapy. There is evidence of improved survival in patients with sarcomatoid differentiation receiving NAC compared to RC alone. The major prognostic factors that affect survival outcomes in VH of UC include histologic variant subtype, patient age, presence of lymphovascular invasion, hydronephrosis, nodal metastasis and advanced T stage at diagnosis. Recent studies demonstrate that VH of UC are heterogenous tumors and responsiveness to NAC may be a function of the molecular subtypes present.Conclusions: Based on these findings, NAC to achieve pathologic downstaging prior to radical cystectomy is recommended for MIBC with VH. Biomarkers identified by molecular profiling with immunohistochemistry will need to be validated as predictors of response to NAC in future trials.

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Bladder Cancer Sample Handling and Reporting: Pathologist's Point of View

Cited by 7 publications

References 89 publications

Recent advances in three-dimensional ultrasound virtual cystoscopy in modeling and local staging for urothelial carcinoma with histopathological correlation: a cohort prospective study

Recent advances in three-dimensional ultrasound virtual cystoscopy in modeling and local staging for urothelial carcinoma with histopathological correlation: a cohort prospective study

Precise diagnosis and treatment of non-muscle invasive bladder cancer - A clinical perspective

Overview of histologic variants of urothelial carcinoma: current trends and narrative review on treatment outcomes

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