Long-term outcome of primary Papillary Urothelial Neoplasm of Low Malignant Potential (PUNLMP) including PUNLMP with inverted growth

Few larger studies have evaluated the long-term outcome after a diagnosis of papillary urothelial neoplasm of low malignant potential (PUNLMP), demonstrating a broad range of recurrence and progression rates. Additionally, no study has addressed the outcome of PUNLMP exhibiting inverted growth. We e...

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Bibliographic Details
Published in:Diagnostic pathology 2015-03, Vol.10 (1), p.3-3, Article 3
Main Authors: Maxwell, Jay P, Wang, Cheng, Wiebe, Nicholas, Yilmaz, Asli, Trpkov, Kiril
Format: Article
Language:English
Subjects:
Adult
Aged
Aged, 80 and over
Alberta
Analysis
Biopsy
Carcinoma - pathology
Carcinoma - therapy
Development and progression
Disease Progression
Female
Humans
Male
Middle Aged
Neoplasm Grading
Neoplasm Invasiveness
Neoplasm Recurrence, Local
Papilloma, Inverted - pathology
Papilloma, Inverted - therapy
Patient outcomes
Risk factors
Time Factors
Treatment Outcome
Tumors
Ureteral Neoplasms - pathology
Ureteral Neoplasms - therapy
Urinary Bladder Neoplasms - pathology
Urinary Bladder Neoplasms - therapy
Urothelium - pathology
Young Adult
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Summary:Few larger studies have evaluated the long-term outcome after a diagnosis of papillary urothelial neoplasm of low malignant potential (PUNLMP), demonstrating a broad range of recurrence and progression rates. Additionally, no study has addressed the outcome of PUNLMP exhibiting inverted growth. We evaluated the long term clinical outcome of primary papillary urothelial neoplasm of low malignant potential (PUNLMP), including PUNLMP with inverted growth in a large single center study. We evaluated 189 primary PUNLMP (177 exophytic, 12 inverted), diagnosed from January 1, 2000 to December 31, 2009, in a centralized uropathology practice. We excluded PUNLMP diagnosed after a previous or with a concurrent urothelial neoplasm. Recurrence was defined as any subsequent urothelial neoplasm, regardless of the grade. Progression was defined as any subsequent higher-grade or invasive urothelial neoplasm. Recurrence and progression were established only if documented on a subsequent biopsy. Descriptive statistical analysis was performed using Microsof Excel software package. The location of PUNLMP included bladder (187) and renal pelvis and ureter (1 each). After a median follow-up of 61 months (range, 9-128 months), 20.1% patients developed a recurrence. Recurrence with PUNLMP only was found in 9% of patients. Subsequent low-grade urothelial carcinoma was documented in 9.5% of patients. Progression to high-grade urothelial carcinoma was found in 1.6% patients (1% with muscle invasion). No patients with recurrent PUNLMP or subsequent low-grade carcinoma demonstrated invasion. All patients with PUNLMP exhibiting an inverted growth had no recurrence or progression on follow-up. In this study, primary PUNLMP recurred primarily either as PUNLMP or low grade urothelial carcinoma. Primary PUNLMP rarely progressed to high grade or invasive carcinoma on long term follow-up. No recurrence or progression was documented on follow-up for PUNLMP that demonstrated exclusively inverted growth. The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/1332825572154074.
ISSN:1746-1596
1746-1596
DOI:10.1186/s13000-015-0234-z