Mp35-18 Agreement Between Transurethral Resection of Bladder Tumor (Turbt) and Radical Cystectomy (Rc) Pathology in Patients With Bladder Cancer Subtype Histology

You have accessJournal of UrologyBladder Cancer: Epidemiology & Evaluation II (MP35)1 May 2024MP35-18 AGREEMENT BETWEEN TRANSURETHRAL RESECTION OF BLADDER TUMOR (TURBT) AND RADICAL CYSTECTOMY (RC) PATHOLOGY IN PATIENTS WITH BLADDER CANCER SUBTYPE HISTOLOGY Dimitra Rafailia Bakaloudi, Elizabeth L. Koehne, Dimitrios Makrakis, Leonidas N. Diamandopoulos, Petros Grivas, Brian R. Winters, Lawrence D. True, Maria S. Tretiakova, Sarah P. Psutka, Sarah K. Holt, Gore L. John, Daniel W. Lin, George R. Schade, Yaw Nyame, Andrew C. Hsieh, John K. Lee, Todd Yezefski, Jessica Hawley, Michael T. Schweizer, Heather H. Cheng, Evan Y. Yu, Funda Vakar-Lopez, Bruce R. Montgomery, and Jonathan Wright Dimitra Rafailia BakaloudiDimitra Rafailia Bakaloudi , Elizabeth L. KoehneElizabeth L. Koehne , Dimitrios MakrakisDimitrios Makrakis , Leonidas N. DiamandopoulosLeonidas N. Diamandopoulos , Petros GrivasPetros Grivas , Brian R. WintersBrian R. Winters , Lawrence D. TrueLawrence D. True , Maria S. TretiakovaMaria S. Tretiakova , Sarah P. PsutkaSarah P. Psutka , Sarah K. HoltSarah K. Holt , Gore L. JohnGore L. John , Daniel W. LinDaniel W. Lin , George R. SchadeGeorge R. Schade , Yaw NyameYaw Nyame , Andrew C. HsiehAndrew C. Hsieh , John K. LeeJohn K. Lee , Todd YezefskiTodd Yezefski , Jessica HawleyJessica Hawley , Michael T. SchweizerMichael T. Schweizer , Heather H. ChengHeather H. Cheng , Evan Y. YuEvan Y. Yu , Funda Vakar-LopezFunda Vakar-Lopez , Bruce R. MontgomeryBruce R. Montgomery , and Jonathan WrightJonathan Wright View All Author Informationhttps://doi.org/10.1097/01.JU.0001009372.61513.54.18AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: TURBT is the primary diagnostic procedure for bladder cancer (BC) and helps determine subsequent care. However, its pathology interpretation may be limited by cautery artifact, lack of spatial orientation of tumor pieces, and sampling bias, especially in cases of incomplete resection. Accurately identifying bladder cancer subtype histology (SH) on TURBT such as plasmacytoid, sarcomatoid and micropapillary is critical to inform clinical decisions. We compared the concordance between TURBT and RC pathology of patients with SH of BC. METHODS: We retrospectively examined TURBT and RC pathology reports of patients who underwent RC at our institutional database from 2010-2022. All slides were reviewed by a GU pathologist. We included patients with pure SH as well as mixed histologies (e.g., urothelial carcinoma with SH present) in either TURBT and RC specimens. Cohen's kappa coefficient was used to determine the degree of agreement between TURBT and RC SH. Agreement was characterized as slight, fair, moderate, substantial, or almost perfect for kappa=0-0.2, 0.21-0.4, 0.41-0.6, 0.61-0.8, and 0.81-1, respectively. Negative kappa values are interpreted as no agreement. RESULTS: From a total of 1161 RC performed, we identified 464 (40%) patients with any amount of SH present on either TURBT or RC. At TURBT, 427 (92%) had SH reported and 59% of these were confirmed at cystectomy. In contrast, 291 RC specimens had SH reported and 56% of these SH were reported on the paired TURBT. We found a high level of agreement (kappa range: 0.5-0.75) between TURBT and RC in pure non-urothelial histology (pure squamous cell carcinoma, pure adenocarcinoma, pure small cell/neuroendocrine carcinoma). In contrast, we found fair (plasmacytoid, small cell, sarcomatoid, squamous) or slight (micropapillary, adenocarcinoma) agreement between TURBT and RC in pts with a mix of urothelial carcinoma and SH (kappa range: 0.1-0.4). CONCLUSIONS: We found low agreement of pathologic detection between TURBT and RC for mixed urothelial carcinoma with subtype histology. In contrast, high level of agreement was noted in pure non-UC histology. Future efforts are needed to develop reliable diagnostic tools for accurate characterization of SH in UC to better inform management. Source of Funding: None © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e588 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Dimitra Rafailia Bakaloudi More articles by this author Elizabeth L. Koehne More articles by this author Dimitrios Makrakis More articles by this author Leonidas N. Diamandopoulos More articles by this author Petros Grivas More articles by this author Brian R. Winters More articles by this author Lawrence D. True More articles by this author Maria S. Tretiakova More articles by this author Sarah P. Psutka More articles by this author Sarah K. Holt More articles by this author Gore L. John More articles by this author Daniel W. Lin More articles by this author George R. Schade More articles by this author Yaw Nyame More articles by this author Andrew C. Hsieh More articles by this author John K. Lee More articles by this author Todd Yezefski More articles by this author Jessica Hawley More articles by this author Michael T. Schweizer More articles by this author Heather H. Cheng More articles by this author Evan Y. Yu More articles by this author Funda Vakar-Lopez More articles by this author Bruce R. Montgomery More articles by this author Jonathan Wright More articles by this author Expand All Advertisement PDF downloadLoading ...