Gutierrez CM, et al. - Ninety-one cases from 82 individuals were involved in the largest study to date following a review of the current English literature of invasive high-grade UCa, in order to manage relevant treatment and enhance patient outcomes of individuals with invasive high-grade urothelial carcinoma (UCa) of the bladder, renal pelvis, ureter, and prostatic urethra arising in a background of urothelial carcinoma with an inverted growth pattern. B ladder, renal pelvis, ureter, and prostatic urethral were primary sites investigated. Recurrent UCa continued in 63 of 82 patients, 16 of 82 advanced with metastatic disease, and 20 of 77 patients with bladder engagement deceased of the disease. This study considerably highlighted the significance of differentiating these tumors from benign mimickers of UCa. Moreover, identification of invasive foci is also crucial in view of the potentially high frequency of recurrence and the possibility of advanced disease in a subset of these patients.