TY - JOUR
T1 - The risk of malignancy of atypical urothelial cells of undetermined significance in patients treated with chemohyperthermia or electromotive drug administration
AU - Pierconti, Francesco
AU - Rossi, Esther
AU - Straccia, Patrizia
AU - Fadda, Guido
AU - Larocca, Luigi Maria
AU - Bassi, Pierfrancesco
AU - Sacco, Emilio
AU - Schinzari, Giovanni
PY - 2018
Y1 - 2018
N2 - BACKGROUND: Chemohyperthermia (C-HT) or electromotive drug administration (EMDA) are alternative therapies to radical cystectomy in patients with non-muscle-invasive bladder cancer who do not respond to intravesical therapy with bacille Calmette-Guérin. METHODS: The authors investigated a group of 87 patients with a diagnosis of high-grade non-muscle-invasive bladder carcinoma or carcinoma in situ. Of these, 45 patients received EMDA of mitomycin (EMDA/MMC) and 42 patients were treated with C-HT and mitomycin therapy (C-HT/MMC). In accordance with the Paris System for Reporting Urinary Cytology, a cytological diagnosis was made and patients with diagnoses of atypical urothelial cells (AUC), suspicious high-grade urothelial carcinoma (SHGUC), or high-grade urothelial carcinoma also underwent histological bladder biopsies. RESULTS: In accordance with the Paris System for Reporting Urinary Cytology, the AUC cases may have cytological features of SHGUC present on atypical degenerated cells. In analyzing the AUC group without the SHGUC cases diagnosed on the basis of degenerated urothelial cells, the authors found a significant association between the AUC category and a negative histological biopsy. The SHGUC group, including cases with a SHGUC diagnosis rendered on degenerated urothelial cells, was associated with high-grade urothelial carcinoma or carcinoma in situ (P= .0269 for patients treated with EMDA/MMC and P= .0049 for patients treated with C-HT/MMC). CONCLUSIONS: In the urine samples from patients treated with EMDA/MMC or C-HT/MMC, a diagnosis of SHGUC could be made even on degenerated urothelial cells when considering cellular degeneration as a "physiological" consequence of the treatment that involves either normal or neoplastic cells.
AB - BACKGROUND: Chemohyperthermia (C-HT) or electromotive drug administration (EMDA) are alternative therapies to radical cystectomy in patients with non-muscle-invasive bladder cancer who do not respond to intravesical therapy with bacille Calmette-Guérin. METHODS: The authors investigated a group of 87 patients with a diagnosis of high-grade non-muscle-invasive bladder carcinoma or carcinoma in situ. Of these, 45 patients received EMDA of mitomycin (EMDA/MMC) and 42 patients were treated with C-HT and mitomycin therapy (C-HT/MMC). In accordance with the Paris System for Reporting Urinary Cytology, a cytological diagnosis was made and patients with diagnoses of atypical urothelial cells (AUC), suspicious high-grade urothelial carcinoma (SHGUC), or high-grade urothelial carcinoma also underwent histological bladder biopsies. RESULTS: In accordance with the Paris System for Reporting Urinary Cytology, the AUC cases may have cytological features of SHGUC present on atypical degenerated cells. In analyzing the AUC group without the SHGUC cases diagnosed on the basis of degenerated urothelial cells, the authors found a significant association between the AUC category and a negative histological biopsy. The SHGUC group, including cases with a SHGUC diagnosis rendered on degenerated urothelial cells, was associated with high-grade urothelial carcinoma or carcinoma in situ (P= .0269 for patients treated with EMDA/MMC and P= .0049 for patients treated with C-HT/MMC). CONCLUSIONS: In the urine samples from patients treated with EMDA/MMC or C-HT/MMC, a diagnosis of SHGUC could be made even on degenerated urothelial cells when considering cellular degeneration as a "physiological" consequence of the treatment that involves either normal or neoplastic cells.
KW - Cancer Research
KW - Chemohyperthermia (C-HT)
KW - Electromotive drug administration (EMDA)
KW - Oncology
KW - Suspicious high-grade urothelial carcinoma (SHGUC)
KW - The Paris System for Reporting Urinary Cytology
KW - Urine cytology
KW - Cancer Research
KW - Chemohyperthermia (C-HT)
KW - Electromotive drug administration (EMDA)
KW - Oncology
KW - Suspicious high-grade urothelial carcinoma (SHGUC)
KW - The Paris System for Reporting Urinary Cytology
KW - Urine cytology
UR - http://hdl.handle.net/10807/116170
UR - http://onlinelibrary.wiley.com/journal/10.1002/(issn)1934-6638
U2 - 10.1002/cncy.21957
DO - 10.1002/cncy.21957
M3 - Article
SN - 1934-662X
VL - 126
SP - 200
EP - 206
JO - Cancer cytopathology
JF - Cancer cytopathology
ER -