Skip to main content

Advertisement

SpringerLink
Log in

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

  • Review and Perspectives
  • Published:
Virchows Archiv Aims and scope Submit manuscript

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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6
Fig. 7
Fig. 8
Fig. 9
Fig. 10
Fig. 11
Fig. 12

Similar content being viewed by others

References

  1. Bochner BH, Hansel DE, Efstathiou JA et al (2016) Urinary bladder. In: Amin MB, Edge SB, Greene FL et al (eds) AJCC cancer staging manual, 8th edn. Springer, Chicago, pp 757–765

    Google Scholar 

  2. Moch H, Humphrey PA, Ulbright TM, Reuter VE (2016) WHO classification of tumours of the urinary system and male genital organs, 4th edn. WHO Press, Geneva

    Google Scholar 

  3. Bostwick DG, Ramnani DM, Cheng L (1999) Diagnosis and grading of bladder cancer and associate lesions. Urol Clin Nth Am 26:493–507

    Article  CAS  Google Scholar 

  4. Epstein JI, Amin MB, Reuter VR, Mostofi FK (1998) The World Health Organization/International Society of Urological Pathology consensus classification of urothelial (transitional cell) neoplasms of the urinary bladder. Bladder Consensus Conference Committee. Am J Surg Pathol 22:1435–1448. https://doi.org/10.1097/00000478-199812000-00001

    Article  CAS  PubMed  Google Scholar 

  5. Jimenez RE, Keany TE, Hardy HT, Amin MB (2000) pT1 Urothelial carcinoma of the bladder: criteria for diagnosis, pitfalls, and clinical implications. Adv Anat Pathol 7:13–25. https://doi.org/10.1097/00125480-200007010-00004

    Article  CAS  PubMed  Google Scholar 

  6. Toll AD, Epstein JI (2012) Invasive low-grade papillary urothelial carcinoma: a clinicopathological analysis of 41 cases. Am J Surg Pathol 36:1081–1086. https://doi.org/10.1097/PAS.0b013e318253d6e0

    Article  PubMed  Google Scholar 

  7. Sylvester RJ, Van der Meijden AP, Oosterlinck W, Witjes JA, Bouffioux C, Denis L et al (2006) Predicting recurrence and progression in individual patients with stage TaT1 bladder cancer using EORTC risk tables: a combined analysis of 2596 patients from seven EORTC trials. Eur Urol 49:466–477. https://doi.org/10.1016/j.eururo.2005.12.031

    Article  PubMed  Google Scholar 

  8. Emiliozzi P, Pansadoro A, Pansadoro V (2008) The optimal management of T1G3 bladder cancer. BJU Int 102:1265–1273. https://doi.org/10.1111/j.1464-410X.2008.07969.x

    Article  PubMed  Google Scholar 

  9. Esrig D, Freeman JA, Stein JP, Skinner DG (1997) Early cystectomy for clinical stage T1 transitional cell carcinoma of the bladder. Semin Urol Oncol 15:154–160

    CAS  PubMed  Google Scholar 

  10. Kulkarni GS, Hakenberg OW, Gschwend JE, Thalmann G, Kassouf W, Kamat A, Zlotta A (2010) An updated critical analysis of the treatment strategy for newly diagnosed high-grade T1 (previously T1G3) bladder cancer. Eur Urol 57:60–70. https://doi.org/10.1016/j.eururo.2009.08.024

    Article  PubMed  Google Scholar 

  11. Martin-Doyle W, Leow JJ, Orsola A, Chang SL, Bellmunt J (2015) Improving selection criteria for early cystectomy in high-grade t1 bladder cancer: a meta-analysis of 15,215 patients. J Clin Oncol 33:643–650. https://doi.org/10.1200/JCO.2014.57.6967

    Article  PubMed  Google Scholar 

  12. Babjuk M, Böhle A, Burger M, Capoun O, Cohen D, Compérat EM, Hernández V, Kaasinen E, Palou J, Rouprêt M, van Rhijn B, Shariat SF, Soukup V, Sylvester RJ, Zigeuner R (2017) EAU guidelines on non–muscle-invasive urothelial carcinoma of the bladder: update 2016. Eur Urol 71:447–461. https://doi.org/10.1016/j.eururo.2016.05.041

    Article  Google Scholar 

  13. Pan CC (2013) Does muscolaris mucosae invasion in extensively lamina propria-invasive high-grade papillary urothelial carcinoma provide additional prognostic information? Am J Surg Pathol 37:459–460. https://doi.org/10.1097/PAS.0b013e3182796e72

    Article  PubMed  Google Scholar 

  14. Soukup V, Duskova J, Pesl M, Capoun O, Feherova Z, Zámečník L et al (2014) The prognostic value of T1 bladder cancer substaging: a single institution retrospective study. Urol Int 92:150–156. https://doi.org/10.1159/000355358

    Article  CAS  PubMed  Google Scholar 

  15. Brimo F, Wu C, Zeizafour N, Tanguay S, Aprikian A, Mansure JJ, Kassouf W (2013) Prognostic factors in T1 bladder urothelial carcinoma: the value of recording milimetric depth of invasion, diameter of invasive carcinoma, and muscolaris propria invasion. Hum Pathol 44:95–102. https://doi.org/10.1016/j.humpath.2012.04.020

    Article  PubMed  Google Scholar 

  16. Hu Z, Mudaliar K, Quek ML, Paner GP, Barkan GA (2014) Measuring the dimension of invasive component in pT1 urothelial carcinoma in transurethral resection specimens can predict time to recurrence. Ann Diagn Pathol 18:49–52. https://doi.org/10.1016/j.anndiagpath.2013.11.002

    Article  PubMed  Google Scholar 

  17. van Rhijn BW, van der Kwast TH, Alkhateeb SS, Fleshner NE, van Leenders GJ, Bostrom PJ, van der Aa M, Kakiashvili DM, Bangma CH, Jewett MA, Zlotta AR (2012) A new and highly prognostic system to discern T1 bladder cancer substage. Eur Urol 61:378–384. https://doi.org/10.1016/j.eururo.2011.10.026

    Article  PubMed  Google Scholar 

  18. Bayraktar Z, Gurbuz G, Taşci AI, Sevin G (2001) Staging error in the bladder tumor: the correlation between stage of TUR and cystectomy. Int Urol Nephrol 33:627–629. https://doi.org/10.1023/a:1020553812554

    Article  CAS  PubMed  Google Scholar 

  19. Bol MG, Baak JP, Buhr-Wildhagen S, Kruse AJ, Kjellevold KH, Janssen EA, Mestad O, Øgreid P (2003) Reproducibility and prognostic variability of grade and lamina propria invasion in stages Ta, T1 urothelial carcinoma of the bladder. J Urol 169:1291–1294. https://doi.org/10.1097/01.ju.0000055471.78783.ae

    Article  PubMed  Google Scholar 

  20. Cheng L, Neumann RM, Weaver AL, Cheville JC, Leibovich BC, Ramnani DM, Scherer BG, Nehra A, Zincke H, Bostwick DG (2000) Grading and staging of bladder carcinoma in transurethral resection specimens. Correlation with 105 matched cystectomy specimens. Am J Clin Pathol 113:275–279. https://doi.org/10.1309/94B6-8VFB-MN9J-1NF5

    Article  CAS  PubMed  Google Scholar 

  21. Compérat E, Egevad L, Lopez-Beltran A, Camparo P, Algaba F, Amin M, Epstein JI, Hamberg H, Hulsbergen-van de Kaa C, Kristiansen G, Montironi R, Pan CC, Heloir F, Treurniet K, Sykes J, van der Kwast T (2013) An interobserver reproducibility study on invasiveness of bladder cancer using virtual microscopy and heatmaps. Histopathology 63:756–766. https://doi.org/10.1111/his.12214

    Article  PubMed  Google Scholar 

  22. Miladi M, Peyromaure M, Zerbib M, Saïghi D, Debré B (2003) The value of a second transurethral resection in evaluating patients with bladder tumours. Eur Urol 43:241–245. https://doi.org/10.1016/s0302-2838(03)00040-x

    Article  PubMed  Google Scholar 

  23. Tosoni I, Wagner U, Sauter G, Egloff M, Knönagel H, Alund G, Bannwart F, Mihatsch MJ, Gasser TC, Maurer R (2000) Clinical significance of interobserver differences in the staging and grading of superficial bladder cancer. BJU Int 85:48–53. https://doi.org/10.1046/j.1464-410x.2000.00356.x

    Article  CAS  PubMed  Google Scholar 

  24. Van Der Meijden A, Sylvester R, Collette L, Bono A, Ten Kate F (2000) The role and impact of pathology review on stage and grade assessment of stages Ta and T1 bladder tumors: a combined analysis of 5 European Organization for Research and Treatment of Cancer trials. J Urol 164:1533–1537. https://doi.org/10.1097/00005392-200011000-00017

    Article  Google Scholar 

  25. Cheng L, Neumann RM, Weaver AL, Spotts BE, Bostwick DG (1999) Predicting cancer progression in patients with stage T1 bladder carcinoma. J Clin Oncol 17:3182–3187. https://doi.org/10.1200/JCO.1999.17.10.3182

    Article  CAS  PubMed  Google Scholar 

  26. Vakar-Lopez F, Shen SS, Zhang S, Tamboli P, Ayala AG, Ro JY (2007) Muscularis mucosae of the urinary bladder revisited with emphasis on its hyperplastic patterns: a study of a large series of cystectomy specimens. Ann Diagn Pathol 11:395–401. https://doi.org/10.1016/j.anndiagpath.2006.12.014

    Article  PubMed  Google Scholar 

  27. Bostwick DG, Lopez-Beltran A (1999) Bladder biopsy interpretation. UPP, Washington DC

    Google Scholar 

  28. Amin MB, Trpkov K, Lopez-Beltran A, Grignon D; Members of the ISUP Immunohistochemistry in Diagnostic Urologic Pathology Group (2014) Best practices recommendations in the application of immunohistochemistry in the bladder lesions: report from the International Society of Urologic Pathology consensus conference. Am J Surg Pathol 38:e20–e34. https://doi.org/10.1097/PAS.0000000000000240

    Article  Google Scholar 

  29. Bovio IM, Al-Quran SZ, Rosser CJ, Algood CB, Drew PA, Allan RW (2010) Smoothelin immunohistochemistry is a useful adjunct for assessing muscularis propria invasion in bladder carcinoma. Histopathology 56:951–956. https://doi.org/10.1111/j.1365-2559.2010.03575.x

    Article  PubMed  Google Scholar 

  30. Chakravarthy R, Ahmed K, Abbasi S, Cotterill A, Parveen N (2011) In response--a modified staining protocol for Smoothelin immunostaining. Virchows Arch 459:119–120. https://doi.org/10.1007/s00428-011-1093-y

    Article  PubMed  Google Scholar 

  31. Council L, Hameed O (2009) Differential expression of immunohistochemical markers in bladder smooth muscle and myofibroblasts, and the potential utility of desmin, smoothelin, and vimentin in staging of bladder carcinoma. Mod Pathol 22:639–650. https://doi.org/10.1038/modpathol.2009.9

    Article  CAS  PubMed  Google Scholar 

  32. Miyamoto H, Sharma RB, Illei PB, Epstein JI (2010) Pitfalls in the use of smoothelin to identify muscularis propria invasion by urothelial carcinoma. Am J Surg Pathol 34:418–422. https://doi.org/10.1097/PAS.0b013e3181ce5066

    Article  PubMed  Google Scholar 

  33. Paner GP, Brown JG, Lapetino S, Nese N, Gupta R, Shen SS, Hansel DE, Amin MB (2010) Diagnostic use of antibody to smoothelin in the recognition of muscularis propria in transurethral resection of urinary bladder tumor (TURBT) specimens. Am J Surg Pathol 34:792–799. https://doi.org/10.1097/PAS.0b013e3181da7650

    Article  PubMed  Google Scholar 

  34. Paner GP, Shen SS, Lapetino S, Venkataraman G, Barkan GA, Quek ML, Ro JY, Amin MB (2009) Diagnostic utility of antibody to smoothelin in the distinction of muscularis propria from muscularis mucosae of the urinary bladder: a potential ancillary tool in the pathologic staging of invasive urothelial carcinoma. Am J Surg Pathol 33:91–98. https://doi.org/10.1097/PAS.0b013e3181804727

    Article  PubMed  Google Scholar 

  35. Lindh C, Nilsson R, Lindstrom ML, Lundin L, Elmberger G (2011) Detection of smoothelin expression in the urinary bladder is strongly dependent on pretreatment conditions: a critical analysis with possible consequences for cancer staging. Virchows Arch 458:665–670. https://doi.org/10.1007/s00428-011-1076-z

    Article  CAS  PubMed  Google Scholar 

  36. Paner GP, Montironi R, Amin MB (2017) Challenges in pathologic staging of bladder cancer: proposals for fresh approaches of assessing pathologic stage in light of recent studies and observations pertaining to bladder histoanatomic variances. Adv Anat Pathol 24:113–127. https://doi.org/10.1097/PAP.0000000000000152

    Article  PubMed  Google Scholar 

  37. Paner GP, Ro JY, Wojcik EM, Venkataraman G, Datta MW, Amin MB (2007) Further characterization of the muscle layers and lamina propria of the urinary bladder by systematic histologic mapping: implications for pathologic staging of invasive urothelial carcinoma. Am J Surg Pathol 31:1420–1429. https://doi.org/10.1097/PAS.0b013e3180588283

    Article  PubMed  Google Scholar 

  38. Lopez-Beltran A, Luque RJ, Mazzucchelli R, Scarpelli M, Montironi R (2002) Changes produced in the urothelium by traditional and newer therapeutic procedures for bladder cancer. J Clin Pathol 55:641–647. https://doi.org/10.1136/jcp.55.9.641

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  39. Lopez-Beltran A, Paner G, Montironi R, Raspollini MR, Cheng L (2017) Iatrogenic changes in the urinary tract. Histopathology 70:10–25. https://doi.org/10.1111/his.13090

    Article  PubMed  Google Scholar 

  40. Lopez-Beltran A, Henriques V, Montironi R, Cimadamore A, Raspollini MR, Cheng L (2019) Variants and new entities of bladder cancer. Histopathology 74:77–96. https://doi.org/10.1111/his.13752

    Article  PubMed  Google Scholar 

  41. Lopez-Beltran A, Algaba F, Berney DM, Boccon-Gibod L, Camparo P, Griffiths D, Mikuz G, Montironi R, Varma M, Egevad L (2011) Handling and reporting of transurethral resection specimens of the bladder in Europe: a web-based survey by the European Network of Uropathology (ENUP). Histopathology 58:579–585. https://doi.org/10.1111/j.1365-2559.2011.03784.x

    Article  PubMed  Google Scholar 

  42. Amin MB, McKenney JK, Paner GP, Hansel DE, Grignon DJ, Montironi R, Lin O, Jorda M, Jenkins LC, Soloway M, Epstein JI, Reuter VE, International Consultation on Urologic Disease-European Association of Urology Consultation on Bladder Cancer 2012 (2013) ICUD-EAU international consultation on bladder cancer 2012: pathology. Eur Urol 63:16–35. https://doi.org/10.1016/j.eururo.2012.09.063

    Article  PubMed  Google Scholar 

  43. Comperat E, Varinot J (2016) Immunochemical and molecular assessment of urothelial neoplasms and aspects of the 2016 World Health Organization classification. Histopathology 69:717–726. https://doi.org/10.1111/his.13025

    Article  PubMed  Google Scholar 

  44. Dixon JS, Gosling A (1983) Histology and fine structure of the muscolaris mucosae of the human bladder. J Anat 136:265–271

    CAS  PubMed  PubMed Central  Google Scholar 

  45. Younes M, Sussman J, True LD (1990) The usefulness of the level of the muscularis mucosae in the staging of invasive transitional cell carcinoma of the urinary bladder. Cancer 66:543–548. https://doi.org/10.1002/1097-0142(19900801)66:3<543::aid-cncr2820660323>3.0.co;2-r

    Article  CAS  PubMed  Google Scholar 

  46. Hasui Y, Osada Y, Kitada S, Nishi S (1994) Significance of invasion to the muscularis mucosae on the progression of superficial bladder cancer. Urology 43:782–786. https://doi.org/10.1016/0090-4295(94)90134-1

    Article  CAS  PubMed  Google Scholar 

  47. Angulo JC, Lopez JI, Grignon DJ, Sanchez-Chapado M (1995) Muscularis mucosa differentiates two populations with different prognosis in stage T1 bladder cancer. Urology 45:47–53. https://doi.org/10.1016/s0090-4295(95)96490-8

    Article  CAS  PubMed  Google Scholar 

  48. Bernardini S, Billerey C, Martin M, Adessi GL, Wallerand H, Bittard H (2001) The predictive value of muscularis mucosae invasion and p53 over expression on progression of stage T1 bladder carcinoma. J Urol 165:42–46. https://doi.org/10.1097/00005392-200101000-00011

    Article  CAS  PubMed  Google Scholar 

  49. Hermann GG, Horn T, Steven K (1998) The influence of the level of lamina propria invasion and the prevalence of p53 nuclear accumulation on survival in stage T1 transitional cell bladder cancer. J Urol 159:91–94. https://doi.org/10.1016/s0022-5347(01)64021-7

    Article  CAS  PubMed  Google Scholar 

  50. Holmäng S, Hedelin H, Anderström C, Holmberg E, Johansson SL (1997) The importance of the depth of invasion in stage T1 bladder carcinoma: a prospective cohort study. J Urol 157:800–804. https://doi.org/10.1016/s0022-5347(01)65044-4

    Article  PubMed  Google Scholar 

  51. Kondylis FI, Demirci S, Ladaga L, Kolm P, Schellhammer PF (2000) Outcomes after intravesical bacillus Calmette-Guerin are not affected by substaging of high grade T1 transitional cell carcinoma. J Urol 163:1120–1123

    Article  CAS  Google Scholar 

  52. Lee JY, Joo HJ, Cho DS, Kim SI, Ahn HS, Kim SJ (2012) Prognostic significance of substaging according to the depth of lamina propria invasion in primary T1 transitional cell carcinoma of the bladder. Kor J Urol 53:317–323. https://doi.org/10.4111/kju.2012.53.5.317

    Article  Google Scholar 

  53. Orsola A, Trias I, Raventós CX, Español I, Cecchini L, Búcar S, Salinas D, Orsola I (2005) Initial high-grade T1 urothelial cell carcinoma: feasibility and prognostic significance of lamina propria invasion microstaging (T1a/b/c) in BCG-treated and BCG-non-treated patients. Eur Urol 48:231–238. https://doi.org/10.1016/j.eururo.2005.04.013

    Article  CAS  PubMed  Google Scholar 

  54. Smits G, Schaafsma E, Kiemeney L, Caris C, Debruyne F, Witjes JA (1998) Microstaging of pT1 transitional cell carcinoma of the bladder: identification of subgroups with distinct risks of progression. Urology 52:1009–1014. https://doi.org/10.1016/s0090-4295(98)00374-4

    Article  CAS  PubMed  Google Scholar 

  55. Farrow GM, Utz DC (1982) Observations on microinvasive transitional cell carcinoma of the urinary bladder. Clin Oncol 1:609–615

    Google Scholar 

  56. Amin MB, Gomez JA, Young RH (1997) Urothelial transitional cell carcinoma with endophytic growth patterns: a discussion of patterns of invasion and problems associated with assessment of invasion in 18 cases. Am J Surg Pathol 21:1057–1068. https://doi.org/10.1097/00000478-199709000-00010

    Article  CAS  PubMed  Google Scholar 

  57. Lopez-Beltran A, Cheng L, Andersson L, Brausi M, de Matteis A, Montironi R, Sesterhenn I, van det Kwast KT, Mazerolles C (2002) Preneoplastic non-papillary lesions and conditions of the urinary bladder: an update based on the Ancona International Consultation. Virchows Arch 440:3–11. https://doi.org/10.1007/s00428-001-0577-6

    Article  PubMed  Google Scholar 

  58. van der Aa MN, van Leenders GJ, Steyerberg EW, van Rhijn BW, Jöbsis AC, Zwarthoff EC, van der Kwast TH (2005) A new system for substaging pT1 papillary bladder cancer: a prognostic evaluation. Hum Pathol 36:981–986. https://doi.org/10.1016/j.humpath.2005.06.017

    Article  CAS  PubMed  Google Scholar 

  59. Bertz S, Denzinger S, Otto W, Wieland WF, Stoehr R, Hofstaedter F, Hartmann A (2011) Substaging by estimating the size of invasive tumour can improve risk stratification in pT1 urothelial bladder cancer-evaluation of a large hospital-based single-centre series. Histopathology 59:722–732. https://doi.org/10.1111/j.1365-2559.2011.03989.x

    Article  PubMed  Google Scholar 

  60. Chang WC, Chang YH, Pan CC (2012) Prognostic significance in substaging of T1 urinary bladder urothelial carcinoma on transurethral resection. Am J Surg Pathol 36:454–461. https://doi.org/10.1097/PAS.0b013e31823dafd3

    Article  PubMed  Google Scholar 

  61. van Rhijn BW, Liu L, Vis AN, Bostrom PJ, Zuiverloon TC, Fleshner NE, van der Aa M, Alkhateeb SS, Bangma CH, Jewett MA, Zwarthoff EC, Bapat B, van der Kwast T, Zlotta AR (2012) Prognostic value of molecular markers, sub-stage and European Organisation for the Research and Treatment of Cancer risk scores in primary T1 bladder cancer. BJU Int 110:1169–1176. https://doi.org/10.1111/j.1464-410X.2012.10996.x

    Article  CAS  PubMed  Google Scholar 

  62. Rouprêt M, Seisen T, Compérat E, Larré S, Mazerolles C, Gobet F et al (2013) Prognostic interest in discriminating muscularis mucosa invasion (T1a vs T1b) in nonmuscle invasive bladder carcinoma: French national multicenter study with central pathology review. J Urol 189:2069–2076. https://doi.org/10.1016/j.juro.2012.11.120

    Article  PubMed  Google Scholar 

  63. Olsson H, Hultman P, Rosell J, Jahnson S (2013) Population-based study on prognostic factors for recurrence and progression in primary stage T1 bladder tumours. Scand J Urol 47:188–195. https://doi.org/10.3109/00365599.2012.719539

    Article  PubMed  Google Scholar 

  64. De Marco V, Cerruto MA, D'Elia C, Brunelli M, Otte O, Minja A et al (2014) Prognostic role of substaging in T1G3 transitional cell carcinoma of the urinary bladder. Mol Clin Oncol 22:575–580. https://doi.org/10.3892/mco.2014.290

    Article  Google Scholar 

  65. Patriarca C, Hurle R, Moschini M, Freschi M, Colombo P, Colecchia M, Ferrari L, Guazzoni G, Conti A, Conti G, Lucianò R, Magnani T, Colombo R (2016) Usefulness of pT1 substaging in papillary urothelial bladder carcinoma. Diagn Pathol 11:6. https://doi.org/10.1186/s13000-016-0466-6

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  66. Lawless M, Gulati R, Tretiakova M (2017) Stalk versus base invasion in pT1 papillary cancers of the bladder: improved substaging system predicting the risk of progression. Histopathology 71:406–414. https://doi.org/10.1111/his.13247

    Article  PubMed  PubMed Central  Google Scholar 

  67. Leivo MZ, Sahoo D, Hamilton Z, Mirsadraei L, Shabaik A, Parsons JK, Kader AK, Derweesh I, Kane C, Hansel DE (2018) Analysis of T1 bladder cancer on biopsy and transurethral resection specimens: comparison and ranking of T1 quantification approaches to predict progression to muscularis propria invasion. Am J Surg Pathol 42:e1–e10. https://doi.org/10.1097/PAS.0000000000000964

    Article  PubMed  Google Scholar 

  68. Giunchi F, Panzacchi R, Capizzi E, Schiavina R, Brunocilla E, Martorana G, D'Errico A, Fiorentino M (2016) Role of inter-observer variability and quantification of muscularis propria in the pathological staging of bladder cancer. Clin Genitourin Cancer 14:e307–e312. https://doi.org/10.1016/j.clgc.2016.01.002

    Article  PubMed  Google Scholar 

  69. van Rhijn BW, van der Kwast TH, Kakiashvili DM, Fleshner NE, van der Aa MN, Alkhateeb S, Bangma CH, Jewett MA, Zlotta AR (2010) Pathological stage review is indicated in primary pT1 bladder cancer. BJU Int 106:206–211. https://doi.org/10.1111/j.1464-410X.2009.09100.x

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Histopathology and Molecular Diagnostics, University Hospital Careggi, Viale Pieraccini, 6, 50139, Florence, Italy

    Maria Rosaria Raspollini

  2. Section of Pathological Anatomy, Department of Biomedical Sciences and Public Health Polytechnic University of the Marche Region, School of Medicine, United Hospitals, Ancona, Italy

    Rodolfo Montironi, Roberta Mazzucchelli & Alessia Cimadamore

  3. Department of Pathology and Laboratory Medicine, Indiana University School of Medicine, Indianapolis, IN, 46202, USA

    Liang Cheng

  4. Unit of Anatomic Pathology, Department of Surgery, Cordoba University Medical School, Cordoba, Spain

    Antonio Lopez-Beltran

  5. Champalimaud Clinical Center, Lisbon, Portugal

    Antonio Lopez-Beltran

Authors
  1. Maria Rosaria Raspollini
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Rodolfo Montironi
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Roberta Mazzucchelli
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Alessia Cimadamore
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Liang Cheng
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Antonio Lopez-Beltran
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

Dr. Raspollini contributed to the writing of manuscript. Dr. Mazzucchelli contributed to the production of the figures. Prof Montironi, Dr. Cimadamore, Prof Cheng, and Prof Lopez-Beltran critically revised the work. All the authors read and approved the final manuscript.

Corresponding author

Correspondence to Maria Rosaria Raspollini.

Ethics declarations

Conflict of interest

The authors declare that there are no conflicts of interest.

Additional information

Publisher’s note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

This article is part of the Topical Collection on Quality in Pathology

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Raspollini, M.R., Montironi, R., Mazzucchelli, R. et al. pT1 high-grade bladder cancer: histologic criteria, pitfalls in the assessment of invasion, and substaging. Virchows Arch 477, 3–16 (2020). https://doi.org/10.1007/s00428-020-02808-6

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00428-020-02808-6

Keywords

Search

Navigation