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IP Archives of Cytology and Histopathology Research


Study of grading and staging of bladder carcinoma in transurethral resection of urinary bladder


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Author Details: Mitul B. Modi, Manthan R. Merja, Nupur R. Shah, Ramrao G. Nilkanthe

Volume : 1

Issue : 1

Online ISSN : 2456-9267

Print ISSN : 2581-5725

Article First Page : 21

Article End Page : 27


Abstract

Introduction: Urinary bladder carcinoma is one of the most common malignancies causing morbidity and mortality.
The most common form of bladder cancer that accounts for about 90% of the bladder cancer is urothelial carcinoma.
Aims of the study: Grading of urothelial carcinoma according to WHO 1999 grading system and evaluation of its prognostic significance on transurethral resection specimens. Evaluation of prognostic significance of stage on transurethral resection specimens Evaluation of transurethral resection of bladder as staging technique.
Material and Methods: Patients, who underwent transurethral resection of bladder tumours were identified from histopathological files of our institute, during the period from 2010 to 2014. The cases that were diagnosed as urothelial carcinomas on transurethral resection specimen and which were followed for 3 years since the lesion first appeared were included in the study. The rest all the cases not fulfilling the above criteria were excluded from the study of recurrences   progression of lesions. Staging was done under TNM system and Grading was carried out according to WHO grading system 1999.
Results: High grade tumors (grade 2 & 3) are associated with high risk of early progression and metastasis. Low grade tumors are recurrent with slower progression. Higher stages are associated with increased risk of metastasis. WHO 1999 grading system can classify urothelial carcinoma into prognostically different groups, which is statically significant. (p<0.01)
Conclusion: Thus, grade is important prognostic factor for superficial urothelial carcinomas and can predict patient outcome and modify patient’s management. The stage is important prognostically parameter in muscle infiltrating carcinomas. Under staging is a problem with transurethral resection specimens of urinary bladder with diagnostic accuracy is 66.66% and staging error of 45.46%.

Key-words:
Urothelial Carcinoma, Transurethral resection, TNM staging