Je. Szakacs et J. Powsang, THE PATHOLOGISTS ROLE IN MULTIDISCIPLINARY MANAGEMENT OF BLADDER-CANCER, Annals of clinical and laboratory science, 24(6), 1994, pp. 481-488
The pathologist plays an important role in management of bladder cance
r, as a member of the multidisciplinary team of urologists, radiation
therapists, and medical oncologists. The therapeutic goal is saving th
e bladder function as long as possible. The pathologic determinants ut
ilized for selection of therapeutic modalities are described in 172 co
nsecutively treated patients with transitional cell carcinoma and 20 p
atients with other forms of bladder tumors during a five year period.
Based on histologic type, pathologic stage, and status of the urotheli
um, 100 patients were treated by resection and intravesical instillati
on of cytostatic drugs or bacille Calmette-Guervin (BCG). Seventy pati
ents underwent radical cystectomy and bladder substitution by continen
t urinary diversion. Serial transurethral resection (TUR) biopsies and
cytologic evaluations were found adequate in evaluating pathologic de
terminants for progression and for survival except in cases of Grade 2
papillary transitional carcinomas where additional experimental studi
es need to be further developed, such as nuclear ploidy and molecular
genetic studies, to identify patients at high risk for progression. Of
the 70 patients with radical cystectomy and 5 with partial cystectomy
, 49 are living, a median of 36.8 months since surgery. There was one
intraoperative death and one post-operative death within 30 days post-
operatively.