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Clinical Paper Volume 6 Issue 1
Is the Use of Cold-Cup Biopsy Necessary at the End of Transurethral Resection of Bladder Tumors?
Jegathesan Thiruchelvam, Kian Tai Chong
Department of Urology, Tan Tock Seng Hospital, Singapore
Received: February 02, 2018 | Published: February 16, 2018
Citation: Thiruchelvam J, Chong KT (2018) Is the Use of Cold-Cup Biopsy Necessary at the End of Transurethral Resection of Bladder Tumors? Urol Nephrol Open Access J 6(1): 00202. DOI: 10.15406/unoaj.2018.06.00202
Abstract
Objective: This study analysed the effects of cold-cup biopsy of resection base after TURBT on tumour staging and cancer outcome.
Methods:This was a retrospective study of newly diagnosed bladder cancer from January 2013 to August 2014 in a single institution, with a mean follow up of 18 months after initial cancer diagnosis. Exclusion criteria were known urothelial cancers or incomplete resection. We correlated clinic-pathological and tumour characteristics with rates of recurrence, progression and outcomes.
Results: Out of 75 patients, those with Ta, T1 and T2 urothelial carcinoma were 33, 30 and 12 respectively. During TURBT, detrusor muscle was seen in 31 main TURBT specimens and 47 separate deep cold-up biopsy tissues. When deep cold-cup biopsy was performed, an additional 25.3% of patients (n=19) had detrusor muscle seen in the pathological report, 11 patients of the Ta/ T1 cohort showed cancer in the biopsy and 1 of 75 patients was upstaged clinically from T1 to T2 disease.
Of the 11 patients in the Ta/T1 group with cancer seen in the deep specimen 4 had early recurrence or persistant tumor. Out of 48 negative cold-cup biopsy specimens, 5 had early recurrence on surveillance cystoscopy or persistant tumor during a relook TURBT. (p=0.042). Tumor size was not related to outcomes in this study.
Conclusion: Deep cold-cup biopsy improved availability and presence of detrusor muscle for pathological assessment. In the Ta and T1 patients, cancer found in the deep cold-cup biopsy increased rates of finding residual tumour and early tumour recurrence.
Keywords: Bladder cancer, Cup biopsy, Deep biopsy, Urothelial carcinoma, Intravesical mitomycin, Radical cystectomy, Muscularis propria, Muscularis mucosa, Cystectomy, Transurethral Resection of Bladder, Bladder tumours
©2018 Thiruchelvam, et al. This is an open access article distributed under the terms of the, which permits unrestricted use, distribution, and build upon your work non-commercially.