CLINICAL-PATHOLOGICAL EVALUATION AND FOLLOW-UP OUTCOMES IN PRIMARY BLADDER TUMOR PATIENTS TREATED AT UROLOGY CLINIC
ISSN
0025-1097
Date Issued
2024
Author(s)
Trifunoski, Aleksandar
Janchulev, Josif
Abstract
Aim. To evaluate the clinical-pathological characteristics, recurrence rate, and progression of primary bladder tumors in patients treated at a tertiary urology center, with a focus on histologic grade, tumor size, and number assessed via cystoscopy.
Methods. This retrospective, observational study included 117 patients with histologically confirmed urothelial carcinoma who underwent initial transurethral resection of bladder tumor (TURBT) at the University Clinic for Urology in Skopje from January 2019 to December 2024. Patients were categorized by gender, tumor invasiveness (pTa, pT1, pT2), histologic grade (PUNLMP, low-grade, high-grade), tumor count, and size. Follow-up was performed using cystoscopy, urine
cytology, and ultrasound at 3, 6, 9, and 12 months. Recurrence was defined as tumor relapse at any of these intervals. Exclusion criteria were: non-urothelial histology, missing data, prior bladder cancer treatment, or
carcinoma in situ (CIS), which was excluded due to its distinct biological behavior.
Results. The mean age of patients was 66.5±9.6 years (range 41-88), with a male-to-female ratio of 3.5:1. Pathological staging showed 43 patients (33.9%) had pTa, 37(29.1%) had pT1, and 37(29.1%) had pT2 tumors. Histologic grading revealed 2 patients (1.6%) with PUNLMP, 37 (29.1%) with low-grade carcinoma, and 78 (64.6%) with high-grade tumors. Non-muscle invasive bladder cancer (NMIBC) was present in 80 patients (63.0%), and muscle-invasive bladder cancer (MIBC) in 37 (29.1%). Recurrence occurred in 14 of 117 followed patients (12.0%). There was no recurrence in PUNLMP cases: 16.2% of low-grade tumors, and 10.2% of high-grade tumors. The relatively lower recurrence in high-grade
cases is attributed to the high proportion of pT2 tumors managed by cystectomy. Tumor multiplicity and size were significant predictors: recurrence was 4.8% in solitary tumors and 50.0% in patients with 3-5 tumors. Tumors >3 cm had a recurrence rate of 24.0%, compared to 5.7% in those <3 cm.
Conclusion. Tumor grade, size, and multiplicity were strongly associated with recurrence following TURBT. These findings emphasize the importance of personalized follow-up based on pathological and cystoscopic features.
Methods. This retrospective, observational study included 117 patients with histologically confirmed urothelial carcinoma who underwent initial transurethral resection of bladder tumor (TURBT) at the University Clinic for Urology in Skopje from January 2019 to December 2024. Patients were categorized by gender, tumor invasiveness (pTa, pT1, pT2), histologic grade (PUNLMP, low-grade, high-grade), tumor count, and size. Follow-up was performed using cystoscopy, urine
cytology, and ultrasound at 3, 6, 9, and 12 months. Recurrence was defined as tumor relapse at any of these intervals. Exclusion criteria were: non-urothelial histology, missing data, prior bladder cancer treatment, or
carcinoma in situ (CIS), which was excluded due to its distinct biological behavior.
Results. The mean age of patients was 66.5±9.6 years (range 41-88), with a male-to-female ratio of 3.5:1. Pathological staging showed 43 patients (33.9%) had pTa, 37(29.1%) had pT1, and 37(29.1%) had pT2 tumors. Histologic grading revealed 2 patients (1.6%) with PUNLMP, 37 (29.1%) with low-grade carcinoma, and 78 (64.6%) with high-grade tumors. Non-muscle invasive bladder cancer (NMIBC) was present in 80 patients (63.0%), and muscle-invasive bladder cancer (MIBC) in 37 (29.1%). Recurrence occurred in 14 of 117 followed patients (12.0%). There was no recurrence in PUNLMP cases: 16.2% of low-grade tumors, and 10.2% of high-grade tumors. The relatively lower recurrence in high-grade
cases is attributed to the high proportion of pT2 tumors managed by cystectomy. Tumor multiplicity and size were significant predictors: recurrence was 4.8% in solitary tumors and 50.0% in patients with 3-5 tumors. Tumors >3 cm had a recurrence rate of 24.0%, compared to 5.7% in those <3 cm.
Conclusion. Tumor grade, size, and multiplicity were strongly associated with recurrence following TURBT. These findings emphasize the importance of personalized follow-up based on pathological and cystoscopic features.
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