In-house pathology review of all specimens before treatment of referred patients certainly is a wise best clinical practice for all entities. It is all the more important for malignancies. In the current manuscript the authors show that this practice remains especially important for patients with bladder cancer. There are many reasons why pathology interpretation of bladder cancer results in greater variation between the primary and secondary or tertiary center review than for any other GU malignancy. Limited tissue samples provided by small cup biopsies and electrocautery artifact are 2 common limitations.
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