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Variant histologies in bladder cancer: Does the centre have an impact in detection accuracy
A. Cimadamore, C. Lonati, E. Di Trapani, O. De Cobelli, M. Rink, S. Zamboni, C. Simeone, F. Soria, A. Briganti, F. Montorsi, L. Afferi, A. Mattei, R. Carando, PI. Ornaghi, A. Tafuri, A. Antonelli, RJ. Karnes, A. Colomer, R. Sanchez-Salas, R....
Language English Country United States
Document type Journal Article
- MeSH
- Cystectomy methods MeSH
- Carcinoma, Transitional Cell * pathology MeSH
- Humans MeSH
- Urinary Bladder pathology MeSH
- Urinary Bladder Neoplasms * diagnosis drug therapy surgery MeSH
- Retrospective Studies MeSH
- Check Tag
- Humans MeSH
- Male MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
OBJECTIVE: To compare the accuracy in detecting variant histologies (VH) at transurethral resection of bladder (TURB) and radical cystectomy (RC) specimen among tertiary referral centres, in order to investigate potential reasons of discrepancies from the pathological point of view. PATIENTS AND METHODS: Clinical and histopathological data of TURB specimen and subsequent cystectomy specimen of 3,445 RC candidate patients have been retrospectively collected from 24 tertiary referral centres between 1980 and 2021. VH considered in the analysis were pure squamous cell carcinoma, urothelial carcinoma with squamous differentiation, pure adenocarcinoma, urothelial carcinoma with glandular differentiation, micropapillary bladder cancer (BCa), neuroendocrine BCa, and other variants. The degree of agreement between TURB and RC concerning the identification of VH was expressed as concordance, classified according to Cohen's kappa coefficient. RESULTS: A VH was reported in 17% of TURB specimens, 45% of which were not confirmed in RC. The lowest concordance rate was reported for micropapillary BCa with 11 out of 18 (61%) centres reporting no agreement, whereas neuroendocrine BCa achieved the highest concordance rate with only 3 centres (17%) reporting no agreement. Our results shows that even among centres with the advantage of a referent uropathologist the micropapillary variant is characterized by scarce accuracy between TURB and RC. Differences in TURB specimen acquisition by the urologist and in sampling methods among different centres are the main limitations of the study. CONCLUSIONS: Accuracy of TURB in detecting VH is poor for certain VH, in particular for micropapillary BCa, with evident variation among centres. Novel diagnostic tools are required to better identify these VH and drive patients toward a personalized treatment.
Clinica Luganese Moncucco Lugano Switzerland
Clinica S Anna Swiss Medical Group Sorengo Switzerland
Clinica Santa Chiara Locarno Switzerland
Department of Medical Oncology Urological Research Institute IRCCS Ospedale San Raffaele Milan Italy
Department of Minimally Invasive and Robotic Urology Wrocław Medical University Wrocław Poland
Department of Oncology and Hematology Oncology Università degli Studi di Milano Milan Italy
Department of Urology 2nd Faculty of Medicine Charles University Prague Czech Republic
Department of Urology ASST Grande Ospedale Metropolitano Niguarda Milano Italy
Department of Urology Azienda Ospedaliera Universitaria Integrata Verona Verona Italy
Department of Urology Hospital Germans Trias 1 Pujol Badalona Spain
Department of Urology Hospital Universitario La Paz Madrid Spain
Department of Urology IEO European Institute of Oncology IRCCS Milan Italy
Department of Urology Institut Mutualiste Montsouris and Universitè Paris Descartes Paris France
Department of Urology IRCCS Humanitas Research Hospital Rozzano Milan Italy
Department of Urology Luzerner Kantonsspital Lucerne Switzerland
Department of Urology Mayo Clinic Rochester MN
Department of Urology Policlinico San Martino Hospital University of Genova Genova Italy
Department of Urology Regina Elena National Cancer Institute IRCCS Rome Italy
Department of Urology Spedali Civili di Brescia Brescia Italy
Department of Urology University Hospital of Toulouse Rangueil Toulouse France
Department of Urology University Hospital Zürich Zürich Switzerland
Department of Urology University Medical Center Hamburg Eppendorf Hamburg Germany
Department of Urology University of Texas Southwestern Medical Center Dallas TX
Department of Urology Weill Cornell Medical College New York NY
Division of Surgery and Interventional Science University College London London UK
Institute for Urology and Reproductive Health Sechenov University Moscow Russia
Sorbonne University GRC 5 Predictive Onco Uro AP HP Urology Pitie Salpetriere Hospital Paris France
University Vita Salute San Raffaele Milan Italy
Urology Unit Surgical Department Fondazione Poliambulanza Istituto Ospedaliero Brescia Italy
References provided by Crossref.org
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- $a Cimadamore, Alessia $u Section of Pathological Anatomy, School of Medicine, Polytechnic University of the Marche Region, United Hospitals, Ancona, Italy. Electronic address: a.cimadamore@staff.univpm.it
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- $a Variant histologies in bladder cancer: Does the centre have an impact in detection accuracy / $c A. Cimadamore, C. Lonati, E. Di Trapani, O. De Cobelli, M. Rink, S. Zamboni, C. Simeone, F. Soria, A. Briganti, F. Montorsi, L. Afferi, A. Mattei, R. Carando, PI. Ornaghi, A. Tafuri, A. Antonelli, RJ. Karnes, A. Colomer, R. Sanchez-Salas, R. Contieri, R. Hurle, C. Poyet, G. Simone, D. D'Andrea, SF. Shariat, A. Galfano, P. Umari, S. Francavilla, M. Roumiguie, C. Terrone, K. Hendricksen, W. Krajewski, O. Buisan, E. Laukhtina, E. Xylinas, M. Alvarez-Maestro, M. Rouprêt, R. Montironi, M. Moschini, European Association of Urology - Young Academic Urologists (EAU-YAU): Urothelial Carcinoma Working Group
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- $a OBJECTIVE: To compare the accuracy in detecting variant histologies (VH) at transurethral resection of bladder (TURB) and radical cystectomy (RC) specimen among tertiary referral centres, in order to investigate potential reasons of discrepancies from the pathological point of view. PATIENTS AND METHODS: Clinical and histopathological data of TURB specimen and subsequent cystectomy specimen of 3,445 RC candidate patients have been retrospectively collected from 24 tertiary referral centres between 1980 and 2021. VH considered in the analysis were pure squamous cell carcinoma, urothelial carcinoma with squamous differentiation, pure adenocarcinoma, urothelial carcinoma with glandular differentiation, micropapillary bladder cancer (BCa), neuroendocrine BCa, and other variants. The degree of agreement between TURB and RC concerning the identification of VH was expressed as concordance, classified according to Cohen's kappa coefficient. RESULTS: A VH was reported in 17% of TURB specimens, 45% of which were not confirmed in RC. The lowest concordance rate was reported for micropapillary BCa with 11 out of 18 (61%) centres reporting no agreement, whereas neuroendocrine BCa achieved the highest concordance rate with only 3 centres (17%) reporting no agreement. Our results shows that even among centres with the advantage of a referent uropathologist the micropapillary variant is characterized by scarce accuracy between TURB and RC. Differences in TURB specimen acquisition by the urologist and in sampling methods among different centres are the main limitations of the study. CONCLUSIONS: Accuracy of TURB in detecting VH is poor for certain VH, in particular for micropapillary BCa, with evident variation among centres. Novel diagnostic tools are required to better identify these VH and drive patients toward a personalized treatment.
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