Pathological diagnosis of bladder cancer workup depends on cystoscopy but because of sampling restriction, the depth of local invasion is often understaged. This study’s findings demonstrate an association between tumor morphology (coral-like and crumb-like) under cystoscopy and depth of invasion.

• This study included data from 386 patients with bladder urothelial carcinoma who underwent follow-up and were divided into coral-like and crumb-like groups.

• Experts found a moderate correlation of bladder tumor morphology with invasion depth, which was linked with invasion status (HR = 8.27).

• Tumor morphology was not an independent factor for overall survival (OS) but was found to be linked with progression free survival (PFS).

• In bladder cancer, outer invasive depth was identified to be an independent factor that was significantly linked with inferior OS and PFS.