title: Comparison of microscopic (pT3a) and gross extravesical extension (pT3b) in pathological staging of bladder cancer: analysis of patient outcomes.
abstract: OBJECTIVE
  To determine the prognostic value of pT3 bladder urothelial carcinoma substaging in patients without lymphatic involvement.
  
  
  METHODS
  Pathologic and clinical data were reviewed on patients who underwent radical cystectomy for urothelial carcinoma between 1991 and 2010. Of the 460 reviewed patients, 74 patients were diagnosed with pathologic T3No urothelial carcinoma of the bladder. The impact of pathologic substaging (pT3a vs. pT3b) was examined to determine the effect on overall and disease-specific survival.
  
  
  RESULTS
  Five years disease-specific and overall survival rates were 46.9 % and 39.6 % for patients with pT3aNo tumor, whereas these ratios were 34.4 and 30.3 %, respectively, for patients with pT3bNo tumor (p > 0.05). Mean disease-specific survival time was 43.94 ± 6.50 months for pT3aNo, while it was 39.01 ± 7.19 months for pT3bNo (p = 0.539). In multivariate cox regression analysis, age (p = 0.459), gender (p = 0.710), urinary diversion type (p = 0.088), and pT3 substaging (p = 0.554) were not noticed as an independent predictive factor for survival.
  
  
  CONCLUSIONS
  Macroscopic extravesical extension (pT3b) is not associated with a worse outcome than pT3a disease in lymph node-negative cases of bladder urothelial carcinoma.
authors: Department of Urology, Katip Celebi University Medicine School, Izmir, Turkey.
authors: Cetin
authors: C
authors: Dincel
authors: Cengiz
authors: C
authors: Kara
authors: Ugur
authors: U
authors: Balci
authors: Kutan
authors: K
authors: Ozer
authors: Sait
authors: S
authors: Ozbir
authors: Ertugrul
authors: E
authors: Sefik
authors: Sacit Nuri
authors: SN
authors: Gorgel
authors: Cengiz
authors: C
authors: Girgin
mesh_terms: D002295:Carcinoma, Transitional Cell / Q000473:pathology* / Q000601:surgery*; D015653:Cystectomy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D011379:Prognosis; D012189:Retrospective Studies; D001749:Urinary Bladder Neoplasms / Q000473:pathology* / Q000601:surgery*