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M. Younes, J. Sussman and L. D. True, “The Usefulness of the Level of the Muscularis Mucosae in the Staging of Invasive Transitional Cell Carcinoma of the Urinary Bladder,” Cancer, Vol. 66, No. 3, 1990, pp. 543-548. doi:10.1002/1097-0142(19900801)66:3<543::AID-CNCR2820660323>3.0.CO;2-R

has been cited by the following article:

• TITLE: Clinicopathological Analysis of Patients with Nonmuscle-Invasive Bladder Cancer Who Underwent Radical Cystectomy

  AUTHORS: Naotaka Nishiyama, Hiroshi Kitamura, Masatoshi Mutoh, Masahiro Yanase, Hiroyuki Iwaki, Tadashi Hasegawa, Taiji Tsukamoto

  KEYWORDS: Clinicopathological Examination; Nonmuscle-Invasive Bladder Cancer; Radical Cystectomy, Pathological Upstaging

  JOURNAL NAME: Surgical Science, Vol.3 No.7, July 19, 2012

  ABSTRACT: Objectives: Surgical specimens obtained at the time of the last transurethral resection of bladder tumor (TURBT) for patients with nonmuscle-invasive bladder cancer (NMIBC) who underwent radical cystectomy were retrospectively evaluated in order to investigate the relationship between pathological variation and upstaging of NMIBC. Methods and Materials: Twenty patients (19 men, 1 woman; aged 69.4 ± 12.1 (mean ± SD) years) diagnosed with NMIBC underwent radical cystectomy during follow-up. Results: Five of the 20 patients (25%) had pathological upstaging in the radical cystectomy specimens. There was a statistical association between pathological upstaging and cancer death (p = 0.002). There were three patterns of pathological variation in the upstaged specimens: 1) in patients with BCG-resistant NMIBC, urothelial carcinoma invaded through the lamina propria; 2) urothelial carcinoma showed diffuse invasion beyond the deep lamina propria, and the cancer cells had infiltrated as single cells and formed nodules; 3) TURBT specimens showed a micropapillary variant. Conclusions: Since these pathological variations correlated with pathological upstaging, they may provide an indication for cystectomy in NMIBC patients.