Tumour front inflammation and necrosis are independent prognostic predictors in high-grade urothelial carcinoma of the bladder

Anjelica Hodgson, Bin Xu, Raj Satkunasivam, Michelle R. Downes

Research output: Contribution to journalArticle

11 Scopus citations

Abstract

AIMS: Inflammation and necrosis have been associated with prognosis in multiple epithelial malignancies. Our objective was to evaluate inflammation and necrosis in a cohort of patients with high-grade urothelial carcinomas of the bladder to determine their association with pathological parameters and their prognostic effect on relapse-free and disease-specific survival.

METHODS: A retrospective cohort that underwent radical cystectomy for urothelial carcinomas (n=235) was evaluated for invasive front and central inflammation using the Klintrup-Makinen assessment method. Necrosis was scored using a four-point scale. The relationship of inflammation and necrosis with stage, nodal status, carcinoma in situ, tumour size, margin status and vascular space invasion and the impact on relapse-free and disease-specific survival were calculated using appropriate statistical tests.

RESULTS: On multivariate analysis, invasive front inflammation (p=0.003) and necrosis (p=0.000) were independent predictors of relapse-free survival. Both invasive front inflammation (p=0.009) and necrosis (p=0.002) again were independent predictors of disease-specific survival. For pathological features, low invasive front inflammation was associated with lymphovascular space invasion (p=0.008), a positive soft tissue margin (p=0.028) and carcinoma in situ (p=0.042). Necrosis was statistically associated with tumours >3 cm in size (p=0.013) and carcinoma in situ (p<0.001).

CONCLUSIONS: Necrosis and invasive front inflammation are additional histological variables with independent prognostic relevance in high-grade urothelial carcinoma of the bladder.

Original languageEnglish (US)
Pages (from-to)154-160
Number of pages7
JournalJournal of Clinical Pathology
Volume71
Issue number2
Early online dateAug 2 2017
DOIs
StatePublished - Feb 1 2018

Keywords

  • bladder
  • inflammation
  • necrosis
  • prognosis
  • urothelial

ASJC Scopus subject areas

  • Pathology and Forensic Medicine

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