Clinical investigations on usefulness of transurethral tru-cut biopsy to confirming the invasive bladder cancer character
Article published in Urologia Polska 2008/61/1.

authors

Piotr Chłosta, Tomasz Szopiński, Artur A. Antoniewicz, Jakub Dobruch, Tomasz Dzik, Janusz Kopczyński, Andrzej Borówka: Oddział Urologii i Zakład Patologii Nowotworów Świętokrzyskiego Centrum Onkologii w Kielcach
Klinika Urologii CMKP i I Zespół Dydaktyki Urologicznej – Oddział Urologii Międzyleskiego Szpitala Specjalistycznego w Warszawie
Zakład Patomorfologii Międzyleskiego Szpitala Specjalistycznego w Warszawie

keywords

urinary bladder, invasive bladder cancer, tru-cut biopsy u staging

summary

Introduction and the aim of the study. Treatment of bladder cancer is influenced by clinical stage of a tumor. Transurethral, cystoscopically guided tru-cut biopsy offer simple way to confirm cancer infiltration of the bladder wall. The aim of this study was an estimation of the usefulness of transurethral tru-cut, core biopsy in the diagnosis of bladder cancer infiltrating detrusor muscle.

Material and method. 96 invasive bladder cancer (IBC) were analyzed. Radiological findings, bimanual examination and cystoscopy were suggestive of IBC in each patient. Transurethral, cystoscopically guided tru-cut biopsy was performed under anesthesia before planned, diagnostic TURBT. Rigid cystoscope with direct working channel and tru-cut automatic Cook 18 G / 48 cm needle or self constructed tru-cut 16 G / 40 cm adapted to work with standard biopsy gun were used. All specimens of biopsy cores underwent microscopic examination after hematoxylin and eosin staining. The histological quality of material from biopsy cores, TURBT resected tissues and radical cystectomy specimens were compared with the special regard to local staging and pathological grade of IBC.

Results. There was no complication of bladder biopsy procedure. In each case tru-cut cystoscopy guided bladder cancer biopsyrevealed muscle infiltration which was in agreement with microscopic examinations of TURBT and radical cystectomy specimens. In 91 (94.8%), pts cancer types diagnosed due to the bladder biopsy and radical cystectomy specimens were identical. Tumor grade (G) was the same in biopsy cores and radical cystectomy specimens in 90 (93.7%) cases.

Conclusions. Endoscopic tru-cut biopsy is simple, short and safe procedure which can be efficiently performed in patients with highly suggestive of muscle infiltration bladder tumor. It allows to collect reliable material for histological assessment. Core bladder biopsy is less invasive than standard TURBT in diagnosis and staging of invasive tumors and seems to be effective in selected cases to confirm malignancy before radical cystectomy.

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