For Patients With Bladder Cancer, Inadequate Biopsies May Increase 5-Year Mortality

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According to a new study published in the journal Cancer, researchers at the University of California Los Angeles in Los Angeles, California, have found that patients with bladder cancer who did not receive an optimal biopsy were more likely to die from their disease compared with those who did receive an optimal biopsy.

For the study, researchers identified 1,865 patients diagnosed with non-invasive bladder cancer during 2004 and 2005. The researchers found about half the time, the surgeon performing the biopsy did not extract an adequate sample or the pathologist did not state the extent of the cancer invasion.

Researchers found that patients with aggressive bladder cancer that were staged appropriately by the surgeons and pathologists had an 8% chance of dying of bladder cancer at 5 years. If the surgeon did not adequately stage the patient, but the physician was alerted of doing so by the pathologist, the 5-year mortality rate was 12%. The 5-year mortality rate was 19% when the surgeon did an inadequate job, and the physician was not alerted by the pathologist.

The findings suggest that the omission of muscle in the biopsy sample is associated with an increased 5-year mortality rate in patients with bladder cancer.

For Patients With Bladder Cancer, Inadequate Biopsies May Increase 5-Year Mortality
Patients with bladder cancer who did not receive an optimal biopsy were more likely to die.

UCLA researchers have shown for the first time that the quality of diagnostic staging using biopsy in patients with bladder cancer is directly linked with survival, meaning those that don't get optimal biopsies are more likely to die from their disease. The two-year study found that about half of bladder cancer patients who were biopsied had insufficient material - meaning there was no bladder wall muscle retrieved - to accurately stage the cancer.

Additionally, the UCLA research team found that a suboptimal biopsy and incorrect tumor staging was associated with a significant increase in deaths from bladder cancer, said study first author Dr. Karim Chamie, an assistant professor of urology and surgical director of the bladder cancer program at UCLA.

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