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Consistency of microstaging pT1 bladder transitional cell carcinoma
  1. Lorna Cottrell (cottrell_lorna{at}yahoo.co.uk)
  1. Southern General Hospital, United Kingdom
    1. Mario Hair (mario.hair{at}tiscali.co.uk)
    1. University of Paisley, United Kingdom
      1. Robert Nairn (robert.nairn{at}nhs.net)
      1. Crosshouse Hospital, United Kingdom

        Abstract

        Evidence that microstaging of pT1 bladder transitional cell carcinoma has prognostic significance has been available for more than 10 years. However, microstaging has not become established in routine pathology practice. The publication of Scottish Intercollegiate Network Guidelines for bladder carcinoma with the recommendation that microstaging of bladder carcinoma become routine, raised questions about training levels and consistency amongst general pathologists. This study was therefore undertaken in a District General Hospital to determine whether it was possible to routinely microstage pT1 transitional cell carcinoma. Amongst six general pathologists, there was moderate agreement (median kappa score 0.510) for a three stage system and substantial agreement (0.623) for a two tier system. In the pilot the study, 7 of 75 (9.3%) cases were excluded because it was not possible to determine the level of superficial infiltration, due mainly to cautery artefact. Microstaging of bladder carcinoma is possible in over 90% of cases and a two tier system is simple and reproducible.

        • bladder neoplasm
        • observer variation
        • prognosis
        • staging
        • transitional cell carcinoma

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