Skip to main content

A View of the Future: The Role of Pathologists

  • Chapter
  • First Online:
Treating Urothelial Bladder Cancer
  • 438 Accesses

Abstract

To ensure the correct and complete report of all histological elements and to allow more accurate comparison of different studies from different institutions, standardisation of pathology reports will become an essential step in the process of improving patient care. The identification and description of rare variant histologies as well as the substaging of T1 tumors will help to improve a better patient’s risk stratification and an even more individualized therapy. Finally, the number of lymphnodes (LNs) examined after radical surgery, the number of positive LNs, the presence/absence of extracapsular invasion, the size of the largest metastases as well as the size of the positive LNs will be fundamental required information that will allow to improve the prediction of patients’ prognosis after radical cystectomy.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 39.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 54.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 54.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Moch H, Humphrey PA, Ulbright TM, Reuter VE. World Health Organization classification of tumours. Pathology and genetics of tumours of the urinary system and male genital organs. Lyon: IARC Press; 2016.

    Google Scholar 

  2. Amin MB, et al. Update for the practicing pathologist: the international consultation on urologic disease-European association of urology consultation on bladder cancer. Mod Pathol. 2015;28:12–30.

    Article  Google Scholar 

  3. http://www.iccr-cancer.org

  4. Alfred Witjes J, et al. Updated 2016 EAU guidelines on muscle-invasive and metastatic bladder cancer. Eur Urol. 2017;71:462–75.

    Article  CAS  PubMed  Google Scholar 

  5. Sangoi AR, Beck AH, Amin MB, Cheng L, Epstein JI, Hansel DE, Iczkowski KA, Lopez-Beltran A, Oliva E, Paner GP, Reuter VE, Ro JY, Shah RB, Shen SS, Tamboli P, McKenney JK. Interobserver reproducibility in the diagnosis of invasive micropapillary carcinoma of the urinary tract among urologic pathologists. Am J Surg Pathol. 2010;34(9):1367–76.

    Article  PubMed  Google Scholar 

  6. Moschini M, Shariat SF, Freschi M, Soria F, D’Andrea D, Abufaraj M, Foerster B, Dell’Oglio P, Zaffuto E, Mattei A, Salonia A, Montorsi F, Briganti A, Gallina A, Colombo R. Is transurethral resection alone enough for the diagnosis of histological variants? A single-center study. Urol Oncol. 2017;35:528.

    Article  PubMed  Google Scholar 

  7. Williams SB, Kamat AM. Optimum management of non-muscle-invasive micropapillary variant urothelial carcinoma: possibility for missed chance of cure? BJU Int. 2016;118:349–50.

    Article  PubMed  Google Scholar 

  8. Paner GP, Annaiah C, Gulmann C, Rao P, Ro JY, Hansel DE, Shen SS, Lopez-Beltran A, Aron M, Luthringer DJ, De Peralta-Venturina M, Cho Y, Amin MB. Immunohistochemical evaluation of novel and traditional markers associated with urothelial differentiation in a spectrum of variants of urothelial carcinoma of the urinary bladder. Hum Pathol. 2014;45:1473–82.

    Article  CAS  PubMed  Google Scholar 

  9. Compérat E, McKenney JK, Hartmann A, Hes O, Bertz S, Varinot J, Brimo F. Large nested variant of urothelial carcinoma: a clinicopathological study of 36 cases. Histopathology. 2017;71(5):703–10.

    Article  PubMed  Google Scholar 

  10. Williamson SR, Zhang S, Lopez-Beltran A, Shah RB, Montironi R, Tan PH, Wang M, Baldridge LA, MacLennan GT, Cheng L. Lymphoepithelioma-like carcinoma of the urinary bladder: clinicopathologic, immunohistochemical, and molecular features. Am J Surg Pathol. 2011;35:474–83.

    Article  PubMed  Google Scholar 

  11. Kirkali Z, et al. Bladder cancer: epidemiology, staging and grading, and diagnosis. Urology. 2005;6:4–34.

    Article  Google Scholar 

  12. Van Rhijn BW, Burger M, Lotan Y, et al. Recurrence and progression of disease in non-muscle-invasive bladder cancer: from epidemiology to treatment strategy. Eur Urol. 2009;56:430–42.

    Article  PubMed  Google Scholar 

  13. Compérat E, et al. An interobserver reproducibility study on invasiveness of bladder cancer using virtual microscopy and heatmaps. Histopathology. 2013;63:756–66.

    Article  PubMed  Google Scholar 

  14. Herr HW, Donat SM, Dalbagni G. Can restaging transurethral resection of T1 bladder cancer select patients for immediate cystectomy? J Urol. 2007;177:75–9.

    Article  PubMed  Google Scholar 

  15. Orsola A, Trias I, Raventos CX, et al. Initial high-grade T1 urothelial cell carcinoma: feasibility and prognostic significance of lamina propria invasion microstaging (T1a/b/c) in BCG-treated and BCG-non-treated patients. Eur Urol. 2005;48:231–8.

    Article  CAS  PubMed  Google Scholar 

  16. Younes M, Sussman J, True LD. Prognostic interest in discriminating muscularis mucosa invasion (T1a vs T1b) in nonmuscle invasive bladder carcinoma: French national multicenter study with central pathology review. Cancer. 1990;66:543–8.

    Article  CAS  PubMed  Google Scholar 

  17. Rouprêt M, et al. Comité de Cancérologie de l’Association Française d’Urologie. J Urol. 2013;189:2069–76.

    Article  PubMed  Google Scholar 

  18. Bruins HM, et al. The impact of the extent of lymphadenectomy on oncologic outcomes in patients undergoing radical cystectomy for bladder cancer: a systematic review. Eur Urol. 2014;66:1065–77.

    Article  PubMed  Google Scholar 

  19. Lee D, et al. Lymph node density vs. the American Joint Committee on Cancer TNM nodal staging system in node-positive bladder cancer in patients undergoing extended or super-extended pelvic lymphadenectomy. Urol Oncol. 2017;16:S1078–439.

    Google Scholar 

  20. Zehnder P, et al. Radical cystectomy with super-extended lymphadenectomy: impact of separate vs en bloc lymph node submission on analysis and outcomes. BJU Int. 2016;117:253–9.

    Article  PubMed  Google Scholar 

  21. Stein JP, Cai J, Groshen S, Skinner DG. Risk factors for patients with pelvic lymph node metastases following radical cystectomy with en bloc pelvic lymphadenectomy: concept of lymph node density. J Urol. 2003;170:35–41.

    Article  PubMed  Google Scholar 

  22. Perry-Keene J, Ferguson P, Samaratunga H, Nacey JN, Delahunt B. Total submission of pelvic lymphadenectomy tissues removed during radical prostatectomy for prostate cancer increases lymph node yield and detection of micrometastases. Histopathology. 2014;64:399–404.

    Article  PubMed  Google Scholar 

  23. Masson-Lecomte A, et al. External validation of extranodal extension and lymph node density as predictors of survival in node-positive bladder cancer after radical cystectomy. Ann Surg Oncol. 2013;20:1389–94.

    Article  PubMed  Google Scholar 

  24. Engvad B, Poulsen MH, Staun PW, Walter S, Marcussen N. Histological step sectioning of pelvic lymph nodes increases the number of identified lymph node metastases. Virchows Arch. 2014;464:45–52.

    Article  CAS  PubMed  Google Scholar 

  25. Wang HJ, Solanki S, Traboulsi S, Kassouf W, Brimo F. Neoadjuvant chemotherapy-related histologic changes in radical cystectomy: assessment accuracy and prediction of response. Hum Pathol. 2016;53:35–40.

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Eva Compérat .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2018 Springer International Publishing AG, part of Springer Nature

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Compérat, E. (2018). A View of the Future: The Role of Pathologists. In: Soria, F., Gontero, P. (eds) Treating Urothelial Bladder Cancer . Springer, Cham. https://doi.org/10.1007/978-3-319-78559-2_14

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-78559-2_14

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-78558-5

  • Online ISBN: 978-3-319-78559-2

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics