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Clinicopathological characteristics of ypT0N0 urothelial carcinoma following neoadjuvant chemotherapy and cystectomy.
- Source :
-
Journal of clinical pathology [J Clin Pathol] 2019 Aug; Vol. 72 (8), pp. 550-553. Date of Electronic Publication: 2019 Jun 04. - Publication Year :
- 2019
-
Abstract
- Aims: To describe a large tertiary care academic centre's experience with patients who achieve a complete pathological response (ie, ypT0N0) following neoadjuvant chemotherapy (NAC) and radical cystectomy (RC) with emphasis on morphological features present in the RC and clinical outcome.<br />Methods: 41 patients with ypT0N0 disease following transurethral resection of bladder tumour (TURBT), NAC and RC with available clinical follow-up information were analysed. Slides from all RCs were reviewed to confirm pathological stage and assess for morphological parameters (eg, foreign body giant cell reaction, dystrophic calcification, scar and fat necrosis).<br />Results: With median follow-up of 32.8 months, the recurrence-free survival at 1 and 5 years was 97.4% and 93.5%, while the overall survival at 3 and 5 years was 94.2% and 88.6%, respectively. No patients died of urothelial carcinoma. Stage assigned at TURBT was 1 pTa (2%), 1 pT1 (2%), 38 pT2 (93%) and 1 pT3a (2%). 17 TURBTs demonstrated variant histology, with the majority of these being squamous (65%). The most common morphological features present at RC were scar (100%), foreign body giant cell reaction (80%), chronic inflammation within lamina propria (68%) and dystrophic calcifications (39%). Other morphological features were less common or absent.<br />Conclusion: ypT0N0 disease at RC portends an excellent prognosis, regardless of stage or variant histology in the TURBT; scar, foreign body giant cell reaction, chronic inflammation and dystrophic calcifications are often present.<br />Competing Interests: Competing interests: None declared.<br /> (© Author(s) (or their employer(s)) 2019. No commercial re-use. See rights and permissions. Published by BMJ.)
- Subjects :
- Aged
Carcinoma mortality
Carcinoma secondary
Chemotherapy, Adjuvant
Databases, Factual
Disease Progression
Female
Humans
Lymphatic Metastasis
Male
Middle Aged
Neoplasm Recurrence, Local
Neoplasm Staging
Progression-Free Survival
Risk Factors
Time Factors
Urinary Bladder Neoplasms mortality
Urinary Bladder Neoplasms pathology
Carcinoma therapy
Cystectomy adverse effects
Cystectomy mortality
Neoadjuvant Therapy adverse effects
Neoadjuvant Therapy mortality
Urinary Bladder Neoplasms therapy
Urothelium pathology
Subjects
Details
- Language :
- English
- ISSN :
- 1472-4146
- Volume :
- 72
- Issue :
- 8
- Database :
- MEDLINE
- Journal :
- Journal of clinical pathology
- Publication Type :
- Academic Journal
- Accession number :
- 31164444
- Full Text :
- https://doi.org/10.1136/jclinpath-2019-205742