Ante Reljić

Correlation of Periacinar Retraction Clefting in Needle Core Biopsies and Corresponding Prostatectomy Specimens of Patients with Prostatic Adenocarcinoma

One of the underemphasized supportive criteria for the diagnosis of prostatic cancer is the presence of retraction clefting around neoplastic glands. We analyzed a series of 152 prostatic cancer cases to determine the frequency, extent, and correlation of periacinar retraction clefting between needle core biopsies (NCB) and corresponding matched radical prostatectomy (RP) specimens. Clefting was significantly more frequent in neoplastic compared to nonneoplastic acini in NBC and RP (p<0.05). There was no significant difference in the frequency of retraction clefting in neoplastic acini between NCB and corresponding RP (p>O.05). We have also found a concordance in matched RP and NCB (Kappa=0.582). We conclude that periacinar retraction clefting appears more frequently in neoplastic acini and could serve as a reliable criterion in the diagnosis of prostatic adenocarcinoma.

We Abandoned ‘Superficial Bladder Cancer’: We Accepted ‘Non-Muscle-Invasive Bladder Cancer’, but ... – On Occasion of the 10th Anniversary of the first EAU Guidelines on Bladder Cancer

practice and experience of the Mainz group of urologists reached the same conclusion (25 years ago!). Stöckle et al. [3] reported a pronounced similarity between T1 (‘superficial’) and T2 (‘infiltrative’) bladder carcinomas regarding cystectomy results and survival. Murphy [4] wrote that ‘the term ‘‘superficial bladder cancer’’ should be abandoned’. His opinion was advocated and argued from different points of view in the noteworthy article by Soloway [5] in 2007. In the meantime, EAU Guidelines on bladder cancer were updated in 2006 and again in 2008 but now using the term ‘non-muscle-invasive’ instead of ‘superficial’ bladder cancer [6] . So the abbreviation NMIBC (non-muscle-invasive bladder cancer) has become generally adopted in the recent literature and the adjective ‘superficial’ has gradually changed to NMIBC [7] . This change in direction of trends in bladder cancer nomenclature was observed through data analysis by Bryan and Wallace [8] . But what have we done? We simply changed one inappropriate term with another, equally imprecise to resolve the essence of the problem. We believe that it is necessary to denote different bladder canDear Editor, The first EAU Guidelines on bladder cancer were published 10 years ago. In this article Ooesterlinck et al. [1] divided bladder cancer into superficial (TIS-Ta-T1) and infiltrative (T2-T3-T4) forms. It was common practice among urologists at this time to use the adjective ‘superficial’ due to one practical reason – those tumors can be removed by transurethral resection. In that way, they ignored the biological differ ences among those dissimilar tumors and all the consequences arising from the use of the misleading term. In spite of the warning voices of pathologists and rare urologists on how incorrect it is to classify drastically different tumors together, urological practices were persistent so the term ‘superficial’ was domesticated in both the spoken and written word. We feel, even nowadays, that it still does not seem useless to stress that different ‘superficial’ tumors require quite different attention, treatment and schedules of follow-up. One of the irregularities pointed out by Sauter and Mihatsch [2] in their article titled ‘Pussycats and baby tigers’ is based on the marked cytogenetic differences between Ta and T1 tumors. Not only the results of cytogenetic research but also the Received: December 5, 2011 Accepted: January 16, 2012 Published online: February 21, 2012