pT1 high-grade bladder cancer: histologic criteria, pitfalls in the assessment of invasion, and substaging

Maria Rosaria Raspollini, Rodolfo Montironi, Roberta Mazzucchelli, Alessia Cimadamore, Liang Cheng, Antonio Lopez-Beltran

Research output: Contribution to journalReview article

Abstract

Most patients with bladder carcinoma are diagnosed with non-muscle-invasive disease, stage Ta, and pT1. Stage remains as the single most important prognostic indicator in urothelial carcinoma. Among the pT1 bladder cancer patients, recurrence and progression of disease occur in 50% and 10%, respectively. The identification of high-risk patients within the pT1 subgroup remains an important clinical goal and an active field of research. Substaging of pT1 disease has been claimed as important histologic discriminator by the 2016 World Health Organization (WHO) classification of the genitourinary tract tumors and by the 8th edition of the American Joint Committee on Cancer (AJCC) staging manual supporting its implementation in clinical practice. Interobserver variation in pT1 diagnosis and the associated pitfalls in pT1 assessment are the critical pathological issues. The aim of this review paper is to provide the practicing pathologist with the state of the art of morphological and immunohistochemical features useful for the diagnosis of early invasive bladder carcinomas, including practical clues on how to avoid relevant interpretative pitfalls, and to summarize the current status of pT1 substaging.

Original languageEnglish (US)
Pages (from-to)3-16
Number of pages14
JournalVirchows Archiv
Volume477
Issue number1
DOIs
StatePublished - Jul 1 2020

Keywords

  • Bladder cancer
  • Pitfalls
  • Stage
  • pT1 sub-staging

ASJC Scopus subject areas

  • Pathology and Forensic Medicine
  • Molecular Biology
  • Cell Biology

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