Unit:
Κατεύθυνση Κλινικοπαθολογοανατομική θεώρηση των νεοπλασιών του ανθρώπουLibrary of the School of Health Sciences
Author:
Fergadis Evangelos-Georgios
Supervisors info:
Ανδρέας Λάζαρης, Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Χαρίκλεια Γακιοπούλου, Αναπληρώτρια Καθηγήτρια, Ιατρική Σχολή, ΕΚΠΑ
Ειρήνη Θυμάρα, Επίκουρη Καθηγήτρια, Ιατρική Σχολή, ΕΚΠΑ
Original Title:
Παθολογοανατομικά χαρακτηριστικά των ουροθηλιακών καρκινωμάτων της ουροδόχου κύστης που επηρεάζουν την πρόγνωση και τους ογκολογικούς χειρισμούς των ασθενών
Translated title:
Pathology caharacteristics of bladder malignancies that affect prognosis and treatment
Summary:
Bladder tumors are classified according to the 2016 World Health Organisation (WHO) Schema. Based on this classification, bladder tumors are divided either in high- or low-grade, defined by the nuclear anaplasia and architectural abnormalities. The invasion of the neoplasm into the layers of the bladder wall and the invasion of the adjacent structures is a major factor in the pathologic staging, affecting both prognosis and treatment, and forming part of the TNM staging system. The most common subtypes of bladder tumors are urothelial, squamous cell an adenocarcinomas.
The pathologic factors that affect the prognosis and treatment of bladder malignancies can be summarized as:
• The depth of the invasion, which is included in the AJCC 8th Edition, has a prominent prognostic implication and plays an important role in the choice of treatment.
• The maximum size of the invasive lesion seems to suggest a prognostic factor.
• The invasion of the muscularis propria is deemed as another prognostic factor, as well as an element that confers to the treatment option.
• The vascular invasion is a poor prognostic factor of the bladder cancer and is associated with pathologic upstaging of the disease after cystectomy.
• Although squamous cell differentiation is not a prognostic factor, it affects the response to chemotherapy and radiotherapy.
• The percentage of micropapillary component of a urothelial tumor is an adverse prognostic factor.
• Activating extracellular domain mutations of HER2 raise the question of targeted treatment.
• The lymphoepithelioma-like component is particularly chemotherapy-sensitive.
• Small cell carcinoma of the bladder has a very aggressive behavior and a poor prognosis.
• PD-L1 expression in cancerous cells or/and in the infiltrating lymphocytes is an element that guides the treatment option, while its prognostic role is still under investigation.
Main subject category:
Health Sciences
Keywords:
Pathology, Urinary bladder, Cancer, Bladder cancer, Urothelial carcinoma, Subtypes, Variants, Prognosis, Risk factors, Infilitrative neoplasm, PD-L1
