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Comparative Application of Different Substaging Techniques for Non-Muscle Invasive Urothelial Carcinoma

  • Mohamed Emad Eldin
  • Rania Makboul
  • Hosny M. Behnsawy
  • Islam F. AbdelkawiEmail author
  • Ahmed M. Moeen
  • Amr Abou Faddan
  • Mohamed Gadelmoula
  • Ahmed A. Shahat
  • Mohamed Atef Abdel-Aziz
  • Moemen M. Hafez
  • D.A. Hameed
Original Article
  • 66 Downloads

Abstract

To evaluate the diagnostic performance and clinical significance of 4 systems of substaging cases with non-muscle invasive urothelial bladder carcinoma. In addition 4 cutoff measures were evaluated for prediction of muscularis-mucosa invasion. Four substaging systems were applied to 57 NMIBC cases to assess which of these reported methods correlates best with recurrence and progression. On univariate regression analysis patients having tumor size more than 3 cm, solid tumor architecture, high grade, substage B, substage T1e, substage ROL 2 and Tumor depth more than 1 mm were associated with higher recurrence. On multivariate analysis all the four substaging systems, tumor size, grade and tumor type had significant prognostic value for recurrence. Regarding progression only the metric substaging method was associated with tumor progression (p = 0.04). However, on univariate and multivariate regression analysis none of the substaging systems showed prognostic significance and only solid tumor architecture and CIS had significant prognostic value for tumor progression. The ROC curve analysis showed that 1 mm depth of invasion had the best accuracy for detection of muscularis-mucosa invasion (80.2%). Using 1 mm cutoff in measuring the depth and 0.5 mm for the diameter of infiltration may provide clinically relevant information to guide a more personalized therapy for NMIBC. Inclusion of both measures in addition to other histopathologic variables may aid in the development of a scoring system.

Keywords

Substaging Non-muscle invasive Urothelial carcinoma Urinary bladder 

Notes

Compliance with Ethical Standards

Conflict of Interest

Authors declare no conflict of interest.

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Copyright information

© Arányi Lajos Foundation 2019

Authors and Affiliations

  • Mohamed Emad Eldin
    • 1
  • Rania Makboul
    • 2
  • Hosny M. Behnsawy
    • 1
  • Islam F. Abdelkawi
    • 1
    Email author
  • Ahmed M. Moeen
    • 1
  • Amr Abou Faddan
    • 1
  • Mohamed Gadelmoula
    • 1
  • Ahmed A. Shahat
    • 1
  • Mohamed Atef Abdel-Aziz
    • 1
  • Moemen M. Hafez
    • 2
  • D.A. Hameed
    • 1
  1. 1.Urology and Nephrology HospitalAssiut UniversityAsyutEgypt
  2. 2.Department of Pathology, Faculty of MedicineAssiut UniversityAssiutEgypt

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