Does it matter whether a T1 high-grade tumor is molecularly classified?

Arnulf Stenzl, David McConkey, Joaquim Bellmunt

Research output: Contribution to journalArticle

Abstract

A 58-yr-old male, 20 pack-year smoker, with hypertension was diagnosed with a single left-side high-grade papillary tumor with peritumoral carcinoma in situ, but no tumor was visible outside the bladder. En bloc resection was performed, and repeat transurethral resection of the bladder at 4 wk found no residual tumor. He was prescribed bacillus Calmette-Guérin (BCG) plus maintenance therapy, and cystoscopy at 9 mo found a T1b high-grade tumor, this time right sided. Is it important that the tumor should be molecularly characterized before a treatment decision is made, or is clinicopathologic characterization still the only viable option at this time? Patient summary: We discussed how new methods in pathology may help us find molecular structures that would help clinicians decide safely between cystectomy and conservative bladder-sparing strategies. The primary superficially infiltrative tumor and its similar recurrence 9 mo later were categorized based on standard clinical criteria, but here we discuss whether recently discovered methods for defining the molecular structure of tumors could mean that more bladder-preserving treatments might be an option.

Original languageEnglish (US)
JournalEuropean Urology Oncology
DOIs
StatePublished - Jan 1 2019

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Keywords

  • DNA damage and repair mutations
  • Genomic profiling
  • Muscle-invasive bladder cancer
  • Muscle-invasive, Non–muscle-invasive bladder cancer
  • The Cancer Genomic Atlas
  • UROMOL

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Surgery
  • Oncology
  • Urology

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