Correlations of tumor depth and width with lymphovascular invasion in non-muscle invasive bladder cancer

Abstract

Purpose: Around 75% of all bladder cancers are classified into nonmuscle invasive bladder cancer (NMIBC). The NMIBC's high recurrence and progressivity rate are most commonly found in tumors invading the lamina propria (LP), classified as staged pT1 when it extended to the LP with a heterogeneous recurrence and progression. This study aimed to correlate the measurement of tumor depth and width to lymphovascular invasion (LVI) in NMIBC. Materials and Methods: A 5-year retrospective analytical study (2015–2019) was conducted in a tertiary hospital in Indonesia. We reassessed and analyzed the tumor depth and width of 64 patients with pT1 bladder cancer based on histopathological reports and analyzed the correlation of tumors and LVI. The depth was reassessed by measuring the transitional urothelium with the LP as an initial marking point, up to the tumor's edge in the LP, and tumor's width by measuring the largest width of one tumor focus in the LP, along with the presence of LVI by histopathological exams. Data were analyzed using the Mann − Whitney test. Results: The participants were 64 patients with pT1 bladder cancer. The mean tumor pT1 invasion depth was 2.03 ± 0.918 mm. The non-LVI group's mean tumor invasion depth was 1.72 ± 0.721 mm, whereas the LVI group was 2.21 ± 0.980 mm. The tumor invasion depth was a significant factor for LVI, whereas the tumor maximum diameter was not. Conclusion: The tumor invasion's depth was significantly associated with the LVI. The pT1 tumor invasion depth measurement might serve as a predictive variable of tumor recurrence and progressivity.

Keywords

• bladder cancer
• lymphovascular invasion
• nonmuscle invasive bladder cancer
• tumor depth