ABSTRACT
Staging Transurethral resection (TUR) is the most reliable procedure for clinical local staging of bladder cancer, and any treatment modality is based upon the pathology specimen obtained at TUR. However, up to 44% to 46% of patients with T1 transitional cell carcinoma of the bladder at TUR are understaged when subsequent cystectomy is performed.15,16
Substaging of T1 bladder cancer refers to invasion above and below the muscularis mucosae (T1A and T1B) or, alternatively, invasion above, at the level of, and below the muscularis mucosae (T1A, T1B and T1C).17 However, a literature review showed that most series do not reveal a significant difference in terms of recurrence and progression on follow-up of substaged groups.18 Whether or not to maintain this subclassification remains a controversial topic. No clear prognostic value can be attributed to substaging of T1 bladder cancer (Table 6.2).
