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Tumor Tip of the Week-Bladder Papillary And In Situ

Scenario:   9-18-2018 TURBT :  noninvasive papillary urothelial carcinoma with adjacent urothelial carcinoma in situ

Question:  How would you assign the clinical T category?

  • cTa
  • cTis

Answer: cTis

Rationale:  

  • CAnswer Forum Post Tis is a higher T category than Ta, therefore this should always be assigned Tis. http://cancerbulletin.facs.org/forums/forum/ajcc-tnm-staging-8th-edition/urinary-tract/urinary-bladder-chapter-62/85952-prognostic-stage-group-for-ta-tis
  • AJCC 8th Edition Chapter 62 [Under Prognostic Factors) Concurrent Urothelial Carcinoma in situ: The presence of urothelial carcinoma in situ has been associated with the presence of multifocal disease in the urinary tract and increased risk of invasive disease. Urothelial carcinoma in  situ that occurs in association with high-grade papillary  urothelial carcinoma should be reported and has been shown  to be a negative prognostic indicator. In such cases, care must be taken to distinguish the “shoulder” (lateral extension) of a high-grade papillary carcinoma from a separate focus of urothelial carcinoma in situ. 21–23AJCC Level of Evidence: II

TIP:  The latest 2019 NAACR Webinar on Bladder is available on the himagine Cancer Registry SharePoint Site.  Be sure to take advantage of these FREE credits purchased for our himagine registrars.

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