Assessment of the changes in tumor grade, size, and pathological stage of bladder tumor in resampling of urothelial tumors as residual tumors and recurrent tumors

Introduction: Because grading and pathological stage of tumor have critical roles in therapeutic decision in urothelial cancers of bladder, the present study aimed to assess changes in tumor grade, size, and pathological stage of tumor (pT) in resampling of bladder tumors as residual tumors and recurrent urothelial tumors. The presence of tumor in bladder within 8 weeks after primary sampling was considered as residual tumor and after that as recurrence of tumor. Methods: This retrospective study was conducted on 154 consecutive patients with bladder cancer who referred to Hasheminejad Kidney Center from 2003 to 2011. In this review, the pathology reports of the residual tumors and recurrence tumors on transurethral resection of the bladder (TUR-B) were assessed.Results: In resampling residual tumors, the grade of tumor in 7.7% of low-grade samples changed to high-grade status. Similarly, in the group with recurrent tumors, the grade of tumor in 17.6% of samples with low grade changed to high-grade status. Increasing the primary tumor size from less than 3 cm to more was found in 15.4% of residual tumors and in 13.2% of those with recurrent tumors with a significant change in both groups. Lamina propria invasion occurred in 39.6% of primary sampling that after resampling, invasion was revealed in 53.4% of residual tumors and in 48.5% of recurrent tumors. With respect to change in pathological stage, the stage remained unchanged in 79.9% of subjects, while changing pTa stage to pT1 stage occurred in 1.9%, changing pTa stage to pT2 stage occurred in 2.6% and changing pT1 stage to pT2 stage occurred in 8.4%.Conclusion: There was a possibility of changing the grade, size and pT in most patients with residual tumors in Re-TUR-B group. A significant number of patients with recurrent tumors may have grade changing, may be due to new mutations. The size and pT may be increased in a number of patients with residual tumors or recurrence tumors indicating significant tumor progression.

Assessment of the changes in tumor grade, size, and pathological stage of bladder tumor in resampling of urothelial tumors as residual tumors and recurrent tumors Keywords:

Urothelial carcinoma , recurrent , residual , grade , stage