Mp35-19 Quantification of Micropapillary Component on Transurethral Resection Samples: Impact on Lymph Node Metastasis at Radical Cystectomy

You have accessJournal of UrologyBladder Cancer: Epidemiology & Evaluation II (MP35)1 May 2024MP35-19 QUANTIFICATION OF MICROPAPILLARY COMPONENT ON TRANSURETHRAL RESECTION SAMPLES: IMPACT ON LYMPH NODE METASTASIS AT RADICAL CYSTECTOMY Andrew M. Wood, Rebecca Campbell, Tarik Benidir, Zaeem Lone, Samuel Haywood, Christopher J. Weight, Mohamed Eltemamy, Reza Alaghehbandan, and Nima Almassi Andrew M. WoodAndrew M. Wood , Rebecca CampbellRebecca Campbell , Tarik BenidirTarik Benidir , Zaeem LoneZaeem Lone , Samuel HaywoodSamuel Haywood , Christopher J. WeightChristopher J. Weight , Mohamed EltemamyMohamed Eltemamy , Reza AlaghehbandanReza Alaghehbandan , and Nima AlmassiNima Almassi View All Author Informationhttps://doi.org/10.1097/01.JU.0001009372.61513.54.19AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Micropapillary (MP) variant urothelial carcinoma is associated with poor response to intravesical therapy and increased risk of occult lymph node (LN) metastasis at radical cystectomy (RC). To date, no studies have evaluated whether percent MP variant present within transurethral resection (TUR) samples impacts these outcomes. Our objective is to evaluate the impact of percentage MP variant on TUR on rates of lymph node (LN) metastasis and survival outcomes. METHODS: A total of 70 patients with MP variant on TUR were identified from a prospectively maintained database of patients undergoing RC between 2007 and 2022. TUR samples were rereviewed by an expert GU pathologist with over ten years of experience. Presence and percent MP component, LVI, CIS, grade, and clinical stage were evaluated. Pathologic outcomes were collected from subsequent RC specimens, and recurrence free (RFS) and overall survival (OS) were estimated via the Kaplan-Meier method. Associations between percent MP and LN metastasis, RFS, and OS were assessed with univariate and multivariate logistic regression and Cox survival analyses as appropriate. RESULTS: 67 of 70 TUR samples were confirmed to contain MP variant urothelial carcinoma on rereview. 34 of 67 (50.6%) patients underwent RC for cT1 disease, the remainder harbored cT2+ disease. 17 of 33 (51.5%) patients with cT2+ disease underwent neoadjuvant chemotherapy (NAC). Mean percent MP was 34.7% in cT1 patients and 27.6% in cT2 patients (p=0.25). On univariate analysis, both MP≥30% (Odds Ratio (OR) 3.24, p=0.025) and clinical T stage 2+ (OR 3.09, p=0.03) were significant predictors of LN metastasis at RC. On multivariate analysis, both MP≥30% (Odds Ratio (OR) 3.79, p=0.017) and clinical T stage 2+ (OR 3.63, p=0.021) remained significant predictors of pathologic node positive disease. The lowest rate of LN metastasis was found in patients with cT1 disease and MP<30% (3/16, 18.7%), versus the highest in cT2+ disease and MP≥30% (12/16, 75%). CONCLUSIONS: Percent MP component on TURBT is associated with increased risk of occult LN metastasis at subsequent RC. Routine pathologic evaluation of percent MP component has the potential to help select which patients with MP might be reasonable candidates for intravesical therapy. Download PPT Source of Funding: None © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e589 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Andrew M. Wood More articles by this author Rebecca Campbell More articles by this author Tarik Benidir More articles by this author Zaeem Lone More articles by this author Samuel Haywood More articles by this author Christopher J. Weight More articles by this author Mohamed Eltemamy More articles by this author Reza Alaghehbandan More articles by this author Nima Almassi More articles by this author Expand All Advertisement PDF downloadLoading ...