Jennifer Gordetsky1, Trinity Bivalacqua2, Mark Schoenberg2, Jonathan I Epstein3. 1. Department of Pathology, The Johns Hopkins Hospital, Baltimore, MD. 2. Department of Urology and Oncology, The Johns Hopkins Hospital, Baltimore, MD. 3. Department of Pathology, The Johns Hopkins Hospital, Baltimore, MD; Department of Urology and Oncology, The Johns Hopkins Hospital, Baltimore, MD. Electronic address: jepstein@jhmi.edu.
Abstract
OBJECTIVE: To evaluate denudation (no urothelium present for evaluation) and atypia (urothelial carcinoma in situ [CIS] cannot be ruled out) on frozen sections (FSs) of ureteral and urethral margins in radical cystectomies and cystoprostatectomies. MATERIALS AND METHODS: In radical cystectomies from 2000-2012, we compared FS diagnoses with the corresponding permanent section of the same tissue (frozen section control [FSC]). We also compared FS to "any CIS," which assessed whether there was any CIS in a given ureter or urethra, combining the diagnoses on "frozen section control" and on all submitted ureteral and urethral sections in a case. RESULTS: We analyzed 1222 ureteral and 366 urethral FSs in 822 surgical cases. On FS for ureters, there were 56 diagnoses of atypia, 19 (33.9%) of which showed CIS on FSC, and 81 diagnoses of denudation, 1 (1.2%) of which showed CIS on FSC. On FS for urethras, there were 12 diagnoses of atypia, 2 (16.7%) of which showed CIS on FSC, and 17 diagnoses of denudation, 1 (5.9%) of which showed CIS on FSC. Twenty-three patients (38.3%) with atypia and 14 patients (15.0%) with denudation on FS had a finding of "any CIS." A diagnosis of either atypia or denudation on FS was predictive of finding CIS on FSC and "any CIS" in a given ureter or urethra (P <.0001). Half of margins positive for CIS on the first FS were converted to a final negative margin by resecting additional tissue. CONCLUSION: After an FS diagnosis of atypia or denudation, urologists should obtain additional margins if surgically feasible.
OBJECTIVE: To evaluate denudation (no urothelium present for evaluation) and atypia (urothelial carcinoma in situ [CIS] cannot be ruled out) on frozen sections (FSs) of ureteral and urethral margins in radical cystectomies and cystoprostatectomies. MATERIALS AND METHODS: In radical cystectomies from 2000-2012, we compared FS diagnoses with the corresponding permanent section of the same tissue (frozen section control [FSC]). We also compared FS to "any CIS," which assessed whether there was any CIS in a given ureter or urethra, combining the diagnoses on "frozen section control" and on all submitted ureteral and urethral sections in a case. RESULTS: We analyzed 1222 ureteral and 366 urethral FSs in 822 surgical cases. On FS for ureters, there were 56 diagnoses of atypia, 19 (33.9%) of which showed CIS on FSC, and 81 diagnoses of denudation, 1 (1.2%) of which showed CIS on FSC. On FS for urethras, there were 12 diagnoses of atypia, 2 (16.7%) of which showed CIS on FSC, and 17 diagnoses of denudation, 1 (5.9%) of which showed CIS on FSC. Twenty-three patients (38.3%) with atypia and 14 patients (15.0%) with denudation on FS had a finding of "any CIS." A diagnosis of either atypia or denudation on FS was predictive of finding CIS on FSC and "any CIS" in a given ureter or urethra (P <.0001). Half of margins positive for CIS on the first FS were converted to a final negative margin by resecting additional tissue. CONCLUSION: After an FS diagnosis of atypia or denudation, urologists should obtain additional margins if surgically feasible.
Authors: E Compérat; J R Srigley; F Brimo; B Delahunt; M Koch; A Lopez-Beltran; V Reuter; H Samaratunga; J H Shanks; T Tsuzuki; T van der Kwast; M Varma; F Webster; D Grignon Journal: Virchows Arch Date: 2020-01-08 Impact factor: 4.064
Authors: Georgios Gakis; Peter C Black; Bernard H Bochner; Stephen A Boorjian; Arnulf Stenzl; George N Thalmann; Wassim Kassouf Journal: Eur Urol Date: 2016-10-06 Impact factor: 20.096