Depth of tumor invasion a significant predictor of T1 bladder cancer progression

Last Modified: November 1, 2001

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Last Updated: 2001-02-02 18:30:55 EST (Reuters Health) - In patients with T1 bladder cancer, the level of muscularis mucosae tumor invasion is a significant independent predictor of disease progression, according to a report by French researchers.

Dr. S. Bernardini and colleagues from the Centre Hospitalo-Universitaire, Besancon reviewed the records of 149 patients with T1 bladder cancer. In these patients, 94 tumors had been diagnosed as stage T1. The mean followup was 64.9 months.

The tumor invasion depth had been identified in all 94 patients. "The frequency by which the muscularis mucosae was identified either partially or totally was about 70%," according to the team's report in the January issue of The Journal of Urology.

The researchers found that 37.2% of the tumors showed p53 nuclear overexpression, Univariate analysis revealed that tumor invasion depth and p53 expression both significantly correlated with disease progression.

"However, on multivariate analysis only invasion depth and associated carcinoma in situ remained independently significant as predictors of progression," Dr. Bernardini's group writes. The researchers believe that "the depth of invasion in stage T1 should be included in the histopathological report" because of its independent predictive ability.

Because the muscularis mucosae layer could not be identified in more than 70% of the patients, "the valid conclusion of this report is that invasion of the muscularis mucosae, if present, should be considered as an independent manifestation of a more aggressive phenotype," Dr. Laurence Klotz from the University of Toronto says in a journal editorial. The clinical role of p53 "remains to be definitively elucidated," he adds.

Reference

  • J Urology 2001;165:42-46. (Abstract not available online at time of posting.)



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