title: Transurethral resection specimens of the bladder: outcome of invasive urothelial cancer involving muscle bundles indeterminate between muscularis mucosae and muscularis propria.
abstract: OBJECTIVE
  Thin muscle fibers on transurethral resection of the bladder (TURB) can represent either muscularis propria destroyed or splayed by urothelial carcinoma or muscularis mucosae, which can be hyperplastic.
  
  
  METHODS
  The data from 94 patients with invasive bladder cancer seen at our institution (1986-2008) with a mean of 25.4 months of follow-up, who had had an uncertain pathologic diagnosis, were analyzed (72 men and 22 women, mean age 69.4 years).
  
  
  RESULTS
  Subsequent restaging TURB or a definitive therapeutic procedure performed ≤3 months after the original TURB in 57 patients revealed that 22 patients (38.6%) had nonmuscle-invasive disease and 32 (56.1%) had Stage pT2 or greater disease. The staging for 3 patients remained ambiguous. Of the 94 patients, 37 did not undergo a restaging/therapeutic procedure within 3 months of their original TURB.
  
  
  CONCLUSIONS
  Restaging TURB is critical when the initial TURB findings are equivocal for muscularis propria invasion. Although this might seem intuitive, 37 of 94 patients did not undergo repeat staging/therapeutic procedures within 3 months of their initial TURB.
authors.affiliation: Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Miyamoto
authors.forename: Jonathan I
authors.initials: JI
authors.lastname: Epstein
mesh_terms: D000368:Aged; D002295:Carcinoma, Transitional Cell / Q000473:pathology* / Q000601:surgery*; D015653:Cystectomy / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D009130:Muscle, Smooth / Q000473:pathology; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D016896:Treatment Outcome; D014521:Urethra; D001749:Urinary Bladder Neoplasms / Q000473:pathology* / Q000601:surgery*