UP-38 Pathological Upstaging in Patients Undergoing Radical Cystectomy for clinically localized Denovo Muscle Invasive Bladder Cancer
Thursday June 27, 2019 from

Ahmed Kotb, Canada

Assistant Professor

Clinical Science

Northern Ontario School of Medicine


Pathological upstaging in patients undergoing radical cystectomy for clinically localized denovo muscle invasive bladder cancer

Waleed Shabana1, Asmaa Ismail1, Hazem Elmansy1, Walid Shahrour1, Owen Prowse1, Ahmed Kotb1.

1Urology, Northern Ontario School of Medicine, Thunder Bay, ON, Canada

Introduction: The aim of the study was to compare the concordance of pathological staging between transurethral resection of bladder tumor (TURBT) and radical cystectomy. The secondary aim was to look for the final pathological outcome of patients with clinically localized muscle invasive bladder carcinoma.

Methods:  Fifty-nine patients underwent radical cystectomy for organ confined denovo T2 muscle invasive bladder cancer over 2 years period. Clinical and pathological characteristics of TUTBT and cystectomy specimen were collected and statistically analyzed. The possibility of the delay in receiving neoadjuvant chemotherapy was tested as a possible contributing factor to final pathological outcome.

Results: Of the 59 patients, 80% were male and 20% were female with mean age 67 + 8.8. All patients had preoperative T2 transitional cell carcinoma. Upstaging was noted in 59% (T3 in 27.1% and T4 in 32.2%). Thirty-six percent of all patients had node-positive disease. Prostate adenocarcinoma was incidentally discovered in 20 (34%) patients. Among patients had neoadjuvant chemotherapy,11(78.5 %) patients had T2 disease while only 3 (21.6%) patients had T3/T4 disease (P=0.001).

Conclusion: Pathological upstaging was detected in more than half of patients undergoing radical cystectomy for clinically localized disease. Neoadjuvant chemotherapy was underutilized and was significantly correlated with no upstaging.

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