[Prognostic factors in 243 transitional carcinomas of the bladder (II): microscopic parameters of the tumor and...

A retrospective study was undertaken in 243 cases of transitional cell carcinoma of the bladder to determine the correlation of tumor microscopic features (mitotic index, histologic grade, internal border of tumor growth, lymphocyte infiltration, necrotic and vascularized areas) and stage with survival. The study comprised 148 superficial tumors (131 papillary, and 17 non-papillary) and 95 deep infiltrating tumors (34 papillary and 61 non-papillary or solid tumors). With regard to the superficial tumors, survival was influenced by the mitotic index (a greater number of mitoses correlated with a worse prognosis), histologic grade (a higher histologic grading correlated with a worse prognosis), internal border of tumor growth (the expansive tumor type showed a better prognosis), and necrosis (wide areas of necrosis correlated with a lower survival rate). Furthermore, a worse prognosis was observed for the non-papillary or solid tumors. Lymphocyte infiltration, however, was not observed to influence survival. As for the deep infiltrating tumors, survival was influenced by the histologic grade, internal border of tumor growth, lymphocyte infiltration (a greater lymphocyte infiltration correlated with a better prognosis), necrosis, and tumor type (papillary or non-papillary). The mitotic index or vascularization showed no influence on survival. A higher tumor stage correlated with a worse prognosis. The prognosis for non-papillary (solid) superficial tumors overlaps that of infiltrating tumors. For this reason, special attention should be focused to these tumors.