Table 4.
Compilation of cases with management changes after review
| Major significant treatment changes | |||||
|---|---|---|---|---|---|
|
| |||||
| Case no. | Original diagnosis | Review diagnosis | Risk group stratification | Change in management | Remarks |
| 1 | TaLG | T2 | NMIBC-LR→ MIBC | Conservative surveillance →RC | |
| 2 | CIS | T2+ LVI+ CIS | NMIBC-HR→ MIBC-HR | BCG→ NAC + RC | |
| 3 | T1HG | T2 | NMIBC-HR→ MIBC | reTURBT + BCG→ RC | |
| 4 | T1HG | T2 | NMIBC-HR→ MIBC | reTURBT + BCG→ RC | |
| 5 | T1HG | T2 | NMIBC-HR→ MIBC | reTURBT + BCG→ RC | |
| 6 | T1HG | T2 | NMIBC-HR→ MIBC | reTURBT + BCG→ RC | |
| 7 | T1HG | T2+ CIS | NMIBC-HR→ MIBC | reTURBT + BCG→ RC | |
| 8 | T1HG | T2+ LVI | NMIBC-HR→ MIBC-HR | reTURBT + BCG→ NAC + RC | |
| 9 | T1HG | T2+ LVI+ CIS+ sarcomatoid | NMIBC-HR→ MIBC-HR | reTURBT+ BCG→NAC + RC | |
| 10 | T1HG+ LVI | T2 | NMIBC-VHR→MIBC | Consider early RC→definite RC | |
| 11 | T2 | T2 | MIBC→ MIBC | RC→ reTURBT | Unsure if MP is invaded in review pathology |
| 12 | T2 | T1HG | MIBC→ NMIBC-HR | RC→reTURBT + BCG | |
| 13 | T2 | T2+ CIS | MIBC→ MIBC | reTURBT→ RC | Unsure if MP is invaded in original pathology |
| 14 | T2 | T2+ LVI+ CIS | MIBC→ MIBC-HR | reTURBT→ NAC + RC | Unsure if MP is invaded in original pathology |
|
| |||||
| Significant treatment changes based on institutional practice | |||||
|
| |||||
| Case no. | Original diagnosis | Review diagnosis | Risk group stratification | Change in management | Remarks |
|
| |||||
| 15 | TaHG + (CIS prostatic ducts) | T1HG + CIS + (CIS prostatic ducts) | NMIBC-HR→ NMIBC-VHR | TURP + BCG→ consider early RC | |
| 16 | T1HG | T1HG + CIS | NMIBC-HR→NMIBC-VHR | reTURBT + BCG→ consider early RC | |
| 17 | T1HG | T1HG + CIS | NMIBC-HR→ NMIBC-VHR | reTURBT + BCG→ consider early RC | |
| 18 | T1HG | T1HG + CIS | NMIBC-HR→ NMIBC-VHR | reTURBT + BCG→ consider early RC | |
| 19 | T1HG | T1HG + CIS | NMIBC-HR→ NMIBC-VHR | reTURBT + BCG→ consider early RC | |
| 20 | T1HG | T1HG + CIS | NMIBC-HR→ NMIBC-VHR | reTURBT + BCG→ consider early RC | |
| 21 | T1HG | T1HG + LVI | NMIBC-HR→ NMIBC-VHR | reTURBT + BCG→ consider early RC | |
| 22 | T2 | T2 + LVI | MIBC→ MIBC-HR | Unclear management → NAC + RC | Change in histological diagnosis from poorly differentiated CA→ urothelial carcinoma |
| 23 | T2 | T2 | MIBC→ MIBC | Unclear management → RC | Change in histological diagnosis from poorly differentiated CA→ urothelial carcinoma |
| 24 | T2 | T2 + LVI | MIBC→ MIBC-HR | NAC before RC | |
| 25 | T2 | T2 + LVI | MIBC→ MIBC-HR | NAC before RC | |
| 26 | T2 | T2 + LVI | MIBC→ MIBC-HR | NAC before RC | |
| 29 | T2 | T2 + LVI | MIBC→ MIBC-HR | NAC before RC | |
| 30 | T2 | T2 + LVI | MIBC→ MIBC-HR | NAC before RC | |
| 31 | T2 | T2 + nested | MIBC→ MIBC-HR | NAC before RC | |
| 32 | T2 | T2 + LVI + micropapillary | MIBC→ MIBC-HR | NAC before RC | |
| 33 | T2 | T2 + LVI + sarcomatoid | MIBC→ MIBC-HR | NAC before RC | |
| 34 | T2 | T2 + LVI | MIBC→ MIBC-HR | NAC before RC | |
BCG: bacillus Calmette-Guerin; CIS: carcinoma in situ; LVI: lymphovascular invasion; MIBC: muscle-invasive bladder tumour; MIBC-HR: high-risk muscle-invasive bladder tumour; MP: muscularis propria; NAC: neoadjuvant chemotherapy; NMIBC-HR: high-risk non-muscle-invasive bladder tumour; NMIBC-LR: low-risk non-muscle-invasive bladder tumour; NMIBC-VHR: very-high-risk non-muscle-invasive bladder tumour; reTURBT: repeat transurethral resection of bladder tumour; RC: radical cystectomy; TaHG: Ta high-grade; TaLG: Ta low-grade; T1HG: T1 high-grade; TURP: transurethral resection of prostate.