![]() The incidence of stage pT0 bladder carcinoma is approximately 10%. Stage pT0 tumor is a condition in which there is no evidence of residual carcinoma in the cystectomy specimen after an initial cancer diagnosis in the biopsy or transurethral resection (TUR) specimens. Practical diagnostic issues, such as lymphovascular invasion, surgical margins, specimen handling, and cancer reporting, will also be discussed. 9 This review will focus on recent progress and controversial issues related to bladder cancer staging. 7, revision of the American Joint Committee on Cancer/International Union Against Cancer/Union Internationale Contre le Cancer (AJCC/UICC) TNM system is the most widely used staging system at this time ( Table 1). It is now recommended that the term ‘superficial’ be entirely eliminated from bladder tumor nomenclature. This designation includes noninvasive papillary urothelial carcinoma (pTa), carcinoma in situ (CIS) (pTis), and tumor invading into the lamina propria (pT1). Historically, the term ‘superficial bladder cancer’ has been used to describe tumors that have not invaded into muscularis propria. Adoption of a uniform staging system permits comparison of therapeutic interventions among different institutions. ![]() 2, 3, 4, 5, 6 An ideal staging system should accurately reflect the natural history of cancer at this site, describe the total cancer burden, assess the extent of spread at the time of diagnosis, and stratify patients into prognostic groups for treatment planning. 1 Pathological stage is the most important determinant of prognosis and treatment for bladder cancer. Essential elements for handling and reporting of bladder tumor specimens will also be discussed.īladder cancer is a significant cause of cancer morbidity and mortality, accounting for an estimated 68 810 new cases and 14 100 cancer deaths in the United States in 2008. This review will discuss recent progress and controversial issues on the staging and substaging of bladder carcinomas. Neither the 1973 nor the 2004 WHO grading system appears to be useful for predicting the clinical outcome of invasive urothelial carcinoma. Recognition of diagnostic pitfalls associated with lamina propria invasion is critical for the evaluation of bladder tumor specimens. The term ‘superficial,’ therefore, is no longer used for bladder tumor nomenclature. It is now recognized that ‘superficial’ bladder carcinomas are a heterogenous group of tumors with diverse biological and clinical manifestations. Accurate staging using the American Joint Committee on Cancer/International Union Against Cancer (AJCC/UICC) TNM system is essential for patient management, and has been reinforced by clinical evidence in recent years. Significant progress has been made in the standardization of bladder neoplasm classification and reporting.
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