Concomitant Carcinoma In Situ Is a Feature of Aggressive Disease in Patients With Organ-Confined TCC at Radical Cystectomy

Shahrokh F. Shariat, Ganesh S. Palapattu, Pierre I. Karakiewicz, Craig G. Rogers, Amnon Vazina, Patrick J. Bastian, Mark P. Schoenberg, Seth P. Lerner, Arthur I. Sagalowsky, Yair Lotan

Research output: Contribution to journalArticle

Abstract

Objectives: Carcinoma in situ (CIS) is a nonpapillary, high-grade, potentially aggressive, and unpredictable manifestation of transitional cell carcinoma (TCC) of the bladder. The aim of this study was to assess whether presence of concomitant CIS has a detrimental effect on cancer control after radical cystectomy. Methods: The records of 812 consecutive patients who underwent radical cystectomy and pelvic lymphadenectomy for bladder TCC at three US academic centres were reviewed. Ninety-nine of 812 (12%) patients had CIS only at radical cystectomy and were excluded from the analyses. Results: Three hundred thirty of the 713 (46.3%) patients had concomitant CIS at radical cystectomy. Patients with TCC involvement of the urethra were more likely to have concomitant CIS than not (61% vs. 40%, p = 0.018). Concomitant CIS was significantly more common in patients with lower cystectomy stages and higher tumour grades. In univariate, but not multivariate, analysis, patients with concomitant CIS versus those without were at increased risk of disease recurrence (p = 0.0371). In patients with organ-confined disease, concomitant CIS was an independent predictor of disease recurrence (p = 0.048 and p = 0.012, respectively) but not bladder cancer-specific mortality (p = 0.160 and p = 0.408, respectively) after adjusting for the effects of standard postoperative features. Conclusions: Concomitant CIS in the cystectomy specimen is common, and patients with concomitant CIS are at increased risk of urethral TCC involvement. The presence of concomitant CIS appears to confer a worse prognosis in patients with non-muscle-invasive TCC treated with radical cystectomy.

Original languageEnglish (US)
Pages (from-to)152-160
Number of pages9
JournalEuropean Urology
Volume51
Issue number1
DOIs
StatePublished - Jan 2007

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Transitional Cell Carcinoma
Cystectomy
Carcinoma in Situ
Urinary Bladder
Recurrence
Urethra
Lymph Node Excision
Urinary Bladder Neoplasms
Neoplasms
Multivariate Analysis

Keywords

  • Bladder cancer
  • Carcinoma in situ
  • Cystectomy
  • Recurrence
  • Survival

ASJC Scopus subject areas

  • Urology

Cite this

Shariat, S. F., Palapattu, G. S., Karakiewicz, P. I., Rogers, C. G., Vazina, A., Bastian, P. J., ... Lotan, Y. (2007). Concomitant Carcinoma In Situ Is a Feature of Aggressive Disease in Patients With Organ-Confined TCC at Radical Cystectomy. European Urology, 51(1), 152-160. https://doi.org/10.1016/j.eururo.2006.08.037

Concomitant Carcinoma In Situ Is a Feature of Aggressive Disease in Patients With Organ-Confined TCC at Radical Cystectomy. / Shariat, Shahrokh F.; Palapattu, Ganesh S.; Karakiewicz, Pierre I.; Rogers, Craig G.; Vazina, Amnon; Bastian, Patrick J.; Schoenberg, Mark P.; Lerner, Seth P.; Sagalowsky, Arthur I.; Lotan, Yair.

In: European Urology, Vol. 51, No. 1, 01.2007, p. 152-160.

Research output: Contribution to journalArticle

Shariat, SF, Palapattu, GS, Karakiewicz, PI, Rogers, CG, Vazina, A, Bastian, PJ, Schoenberg, MP, Lerner, SP, Sagalowsky, AI & Lotan, Y 2007, 'Concomitant Carcinoma In Situ Is a Feature of Aggressive Disease in Patients With Organ-Confined TCC at Radical Cystectomy', European Urology, vol. 51, no. 1, pp. 152-160. https://doi.org/10.1016/j.eururo.2006.08.037
Shariat, Shahrokh F. ; Palapattu, Ganesh S. ; Karakiewicz, Pierre I. ; Rogers, Craig G. ; Vazina, Amnon ; Bastian, Patrick J. ; Schoenberg, Mark P. ; Lerner, Seth P. ; Sagalowsky, Arthur I. ; Lotan, Yair. / Concomitant Carcinoma In Situ Is a Feature of Aggressive Disease in Patients With Organ-Confined TCC at Radical Cystectomy. In: European Urology. 2007 ; Vol. 51, No. 1. pp. 152-160.
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abstract = "Objectives: Carcinoma in situ (CIS) is a nonpapillary, high-grade, potentially aggressive, and unpredictable manifestation of transitional cell carcinoma (TCC) of the bladder. The aim of this study was to assess whether presence of concomitant CIS has a detrimental effect on cancer control after radical cystectomy. Methods: The records of 812 consecutive patients who underwent radical cystectomy and pelvic lymphadenectomy for bladder TCC at three US academic centres were reviewed. Ninety-nine of 812 (12{\%}) patients had CIS only at radical cystectomy and were excluded from the analyses. Results: Three hundred thirty of the 713 (46.3{\%}) patients had concomitant CIS at radical cystectomy. Patients with TCC involvement of the urethra were more likely to have concomitant CIS than not (61{\%} vs. 40{\%}, p = 0.018). Concomitant CIS was significantly more common in patients with lower cystectomy stages and higher tumour grades. In univariate, but not multivariate, analysis, patients with concomitant CIS versus those without were at increased risk of disease recurrence (p = 0.0371). In patients with organ-confined disease, concomitant CIS was an independent predictor of disease recurrence (p = 0.048 and p = 0.012, respectively) but not bladder cancer-specific mortality (p = 0.160 and p = 0.408, respectively) after adjusting for the effects of standard postoperative features. Conclusions: Concomitant CIS in the cystectomy specimen is common, and patients with concomitant CIS are at increased risk of urethral TCC involvement. The presence of concomitant CIS appears to confer a worse prognosis in patients with non-muscle-invasive TCC treated with radical cystectomy.",
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T1 - Concomitant Carcinoma In Situ Is a Feature of Aggressive Disease in Patients With Organ-Confined TCC at Radical Cystectomy

AU - Shariat, Shahrokh F.

AU - Palapattu, Ganesh S.

AU - Karakiewicz, Pierre I.

AU - Rogers, Craig G.

AU - Vazina, Amnon

AU - Bastian, Patrick J.

AU - Schoenberg, Mark P.

AU - Lerner, Seth P.

AU - Sagalowsky, Arthur I.

AU - Lotan, Yair

PY - 2007/1

Y1 - 2007/1

N2 - Objectives: Carcinoma in situ (CIS) is a nonpapillary, high-grade, potentially aggressive, and unpredictable manifestation of transitional cell carcinoma (TCC) of the bladder. The aim of this study was to assess whether presence of concomitant CIS has a detrimental effect on cancer control after radical cystectomy. Methods: The records of 812 consecutive patients who underwent radical cystectomy and pelvic lymphadenectomy for bladder TCC at three US academic centres were reviewed. Ninety-nine of 812 (12%) patients had CIS only at radical cystectomy and were excluded from the analyses. Results: Three hundred thirty of the 713 (46.3%) patients had concomitant CIS at radical cystectomy. Patients with TCC involvement of the urethra were more likely to have concomitant CIS than not (61% vs. 40%, p = 0.018). Concomitant CIS was significantly more common in patients with lower cystectomy stages and higher tumour grades. In univariate, but not multivariate, analysis, patients with concomitant CIS versus those without were at increased risk of disease recurrence (p = 0.0371). In patients with organ-confined disease, concomitant CIS was an independent predictor of disease recurrence (p = 0.048 and p = 0.012, respectively) but not bladder cancer-specific mortality (p = 0.160 and p = 0.408, respectively) after adjusting for the effects of standard postoperative features. Conclusions: Concomitant CIS in the cystectomy specimen is common, and patients with concomitant CIS are at increased risk of urethral TCC involvement. The presence of concomitant CIS appears to confer a worse prognosis in patients with non-muscle-invasive TCC treated with radical cystectomy.

AB - Objectives: Carcinoma in situ (CIS) is a nonpapillary, high-grade, potentially aggressive, and unpredictable manifestation of transitional cell carcinoma (TCC) of the bladder. The aim of this study was to assess whether presence of concomitant CIS has a detrimental effect on cancer control after radical cystectomy. Methods: The records of 812 consecutive patients who underwent radical cystectomy and pelvic lymphadenectomy for bladder TCC at three US academic centres were reviewed. Ninety-nine of 812 (12%) patients had CIS only at radical cystectomy and were excluded from the analyses. Results: Three hundred thirty of the 713 (46.3%) patients had concomitant CIS at radical cystectomy. Patients with TCC involvement of the urethra were more likely to have concomitant CIS than not (61% vs. 40%, p = 0.018). Concomitant CIS was significantly more common in patients with lower cystectomy stages and higher tumour grades. In univariate, but not multivariate, analysis, patients with concomitant CIS versus those without were at increased risk of disease recurrence (p = 0.0371). In patients with organ-confined disease, concomitant CIS was an independent predictor of disease recurrence (p = 0.048 and p = 0.012, respectively) but not bladder cancer-specific mortality (p = 0.160 and p = 0.408, respectively) after adjusting for the effects of standard postoperative features. Conclusions: Concomitant CIS in the cystectomy specimen is common, and patients with concomitant CIS are at increased risk of urethral TCC involvement. The presence of concomitant CIS appears to confer a worse prognosis in patients with non-muscle-invasive TCC treated with radical cystectomy.

KW - Bladder cancer

KW - Carcinoma in situ

KW - Cystectomy

KW - Recurrence

KW - Survival

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