A 70-year-old woman comes to the oncologist for a follow-up appointment. She was recently diagnosed with transitional cell carcinoma of the bladder. Which of the following is most likely to suggest the greatest need for cystectomy in this patient?
A) High Ki-67 index with in situ histology
B) Low Ki-67 index with in situ histology
C) Minimal anaplasia and few mitoses with evidence of microinvasion
D) Marked anaplasia and many mitoses without evidence of microinvasion
E) Poorly differentiated carcinoma confined to the mucosa
