{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,23]],"date-time":"2026-08-23T14:47:42Z","timestamp":1787496462362,"version":"build-2736575974"},"reference-count":28,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2025,3,26]],"date-time":"2025-03-26T00:00:00Z","timestamp":1742947200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["bjui-journals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJU International"],"published-print":{"date-parts":[[2025,8]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To evaluate the impact of discordant histological diagnoses between transurethral resection of bladder tumour (TURBT) and radical cystectomy (RC) on cancer\u2010specific mortality (CSM) in patients with bladder cancer (BCa).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patients and Methods<\/jats:title>\n                    <jats:p>We relied on a multi\u2010institutional database collecting data of patients with BCa who underwent TURBT and subsequent RC from nine centres between 2000 and 2023. We tested concordance rates between TURBT and RC in detecting urothelial carcinoma of the urinary bladder (UCUB) as well as non\u2010UCUB hystological subtypes, using RC as the reference standard. Concordance was defined as the agreement between a specific histological subtype identified both at TURBT and RC and evaluated according to Cohen's kappa coefficient. Subsequently, survival analyses consisted of Kaplan\u2013Meier plots and multivariable Cox regression (MCR) models addressing CSM according to concordance between TURBT and RC (namely, concordant vs discordant).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Overall, 3160 patients were identified. Of these, 2762 (87%) harboured UCUB and 398 (13%) non\u2010UCUB at TURBT vs 2481 (79%) UCUB and 679 (21%) non\u2010UCUB at RC. There were 683 (21.6%) patients with a discordant diagnosis between TURBT and RC. The overall concordance in detecting non\u2010UCUB subtypes was defined as fair concordance (Cohen's kappa coefficient: 0.32). In MCR models, a discordant diagnosis exhibited higher CSM relative to those with a concordant diagnosis (hazard ratio [HR] 1.3, 95% confidence interval [CI] 1.1\u20131.6;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.002). In a sensitivity analysis including patients with UCUB not exposed to neoadjuvant chemotherapy, this survival disadvantage was even higher (HR 1.5, 95% CI 1.1\u20131.7;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.04).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>A discordant histopathological diagnosis between TURBT and RC is associated with higher CSM rates, particularly in cases initially misdiagnosed as UCUB. However, we also observed a moderate concordance between TURBT and RC in identifying non\u2010UCUB subtypes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/bju.16714","type":"journal-article","created":{"date-parts":[[2025,3,29]],"date-time":"2025-03-29T03:28:49Z","timestamp":1743218929000},"page":"336-343","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["The impact of histopathological evaluation at transurethral resection of bladder tumour on survival in radical cystectomy candidates"],"prefix":"10.1111","volume":"136","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-0494-7839","authenticated-orcid":false,"given":"Mario","family":"de Angelis","sequence":"first","affiliation":[{"name":"Division of Experimental Oncology\/Unit of Urology URI, Urological Research Institute, IRCCS San Raffaele Scientific Institute  Milan 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Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0113-9920","authenticated-orcid":false,"given":"Chiara","family":"Lonati","sequence":"additional","affiliation":[{"name":"Department of Urology Spedali Civili of Brescia  Brescia Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-9363-682X","authenticated-orcid":false,"given":"Giovanni","family":"Tremolada","sequence":"additional","affiliation":[{"name":"Division of Experimental Oncology\/Unit of Urology URI, Urological Research Institute, IRCCS San Raffaele Scientific Institute  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paolo","family":"Zaurito","sequence":"additional","affiliation":[{"name":"Division of Experimental Oncology\/Unit of Urology URI, Urological Research Institute, IRCCS San Raffaele Scientific Institute  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandro","family":"Viti","sequence":"additional","affiliation":[{"name":"Division of Experimental Oncology\/Unit of Urology URI, Urological Research Institute, IRCCS San Raffaele Scientific Institute  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7828-6876","authenticated-orcid":false,"given":"Francesco","family":"Pellegrino","sequence":"additional","affiliation":[{"name":"Division of Experimental Oncology\/Unit of Urology URI, Urological Research Institute, IRCCS San Raffaele Scientific Institute  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gennaro","family":"Musi","sequence":"additional","affiliation":[{"name":"Department of Urology IEO European Institute of Oncology, IRCCS  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ottavio","family":"De Cobelli","sequence":"additional","affiliation":[{"name":"Department of Urology IEO European Institute of Oncology, IRCCS  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Rink","sequence":"additional","affiliation":[{"name":"Department of Urology University Medical Center Hamburg\u2010Eppendorf  Hamburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5472-1933","authenticated-orcid":false,"given":"Luca","family":"Afferi","sequence":"additional","affiliation":[{"name":"Department of Urology Luzerner Kantonsspital  Lucerne Switzerland"},{"name":"Department of Urology Kantonsspital Aarau  Aarau Switzerland"},{"name":"Department of Urology Fundacio Puigvert  Barcelona 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Angela","family":"Cerruto","sequence":"additional","affiliation":[{"name":"Department of Urology Azienda Ospedaliera Universitaria Integrata Verona  Verona Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6244-4120","authenticated-orcid":false,"given":"Stefania","family":"Zamboni","sequence":"additional","affiliation":[{"name":"Department of Urology Spedali Civili of Brescia  Brescia Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nazareno","family":"Suardi","sequence":"additional","affiliation":[{"name":"Department of Urology Spedali Civili of Brescia  Brescia Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pierre","family":"Karakiewicz","sequence":"additional","affiliation":[{"name":"Cancer Prognostics and Health Outcomes Unit, Division of Urology University of Montr\u00e9al Health Centre  Montr\u00e9al Qu\u00e9bec 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S.","family":"Mertens","sequence":"additional","affiliation":[{"name":"Department of Urology Netherlands Cancer Institute  Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8953-0272","authenticated-orcid":false,"given":"Ekaterina","family":"Laukhtina","sequence":"additional","affiliation":[{"name":"Department of Urology, Comprehensive Cancer Center Medical University of Vienna  Vienna Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benjamin","family":"Pradere","sequence":"additional","affiliation":[{"name":"Department of Urology UROSUD La Croix Du Sud Hospital  Quint\u2010Fonsegrives France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Necchi","sequence":"additional","affiliation":[{"name":"Division of Experimental Oncology\/Unit of Urology URI, Urological Research Institute, IRCCS San Raffaele Scientific Institute  Milan 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A single\u2010center study","volume":"35","author":"Moschini M","year":"2017","journal-title":"Urol Oncol Semin Orig Investig"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.euf.2019.09.003"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.urolonc.2022.01.008"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.euf.2021.04.005"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1111\/bju.16296"},{"key":"e_1_2_9_21_1","volume-title":"TNM Classification of Malignant Tumors","author":"Brierley JD","year":"2016"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2016.02.028"},{"key":"e_1_2_9_23_1","doi-asserted-by":"publisher","DOI":"10.1093\/inthealth\/ihu010"},{"key":"e_1_2_9_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2023.08.016"},{"key":"e_1_2_9_25_1","first-page":"106","article-title":"Does neoadjuvant chemotherapy diminish the sex disparity in bladder cancer survival after radical cystectomy?","volume":"40","author":"Venkat S","year":"2022","journal-title":"Urol Oncol Semin Orig Invest"},{"key":"e_1_2_9_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.urolonc.2024.09.015"},{"key":"e_1_2_9_27_1","unstructured":"The R project for statistical computing. 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