Bladder Cancer: A Comparison Between Non-urothelial Variant Histology and Urothelial Carcinoma Across All Stages and Treatment Modalities

Deuker, Marina; Martin, Thomas; Stolzenbach, Franziska; Rosiello, Giuseppe; Ruvolo, Claudia Collà; Nocera, Luigi; Tian, Zhe; Becker, Andreas; Kluth, Luis A.; Roos, Frederik C.; Tilki, Derya; Shariat, Shahrokh F.; Black, Peter C.; Kassouf, Wassim; Saad, Fred; Chun, Felix K.‐H.; Karakiewicz, Pierre I.

doi:10.1016/j.clgc.2020.07.011

Cited by 41 publications

(26 citation statements)

References 22 publications

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“…In a recent report, the presence of NMIBC with MV morphology at first diagnosis was seen at a significantly lower rate than pure UC (35.5 vs. 79.1%) [39], in keeping with a previous study [110]. Moreover, pT1 MV-UC is often subject to both underreporting and understaging at TURB [111], due to its intrinsic morphological features, and disagreement may ensue even among expert pathologists.…”

Section: Micropapillary Variantsupporting

confidence: 78%

“…It was the most predictive factor of progression at multivariate analysis, along with LVI; therefore, these two parameters have been integrated in an updated clinically applicable decision-making tool [70]. Accordingly, VH was among the most important prognostic factors in a series of T1 HG NMIBC undergoing RC [71], in keeping with other studies [39]. Conversely, VH was not a prognostic parameter of recurrence and progression in two recent series of 970 and 428 patients with primary and high-risk NMIBC, respectively [72,73].…”

Section: Nmibc With Vh: Critical Issuesmentioning

confidence: 79%

“…According to a recent SEER database analysis, overall VH-UC patients presented at a more advanced TNM stage than pure UC patients [39], with NMIBC representing approximately a quarter of all VH-UC, with the vast majority being T1 tumors [40]. The relatively low rate of VH-NMIBC at TURB compared to pure UC had already been reported by many authors, and may be due to the more common understaging at the time of TUR in this setting, which has been shown to be significantly associated with a poorer overall survival (OS; 1.4 vs. 10.6 years, p < 0.001) [41][42][43], suggesting the need to perform re-TUR in T1 VH-NMIBC regardless of the presence of detrusor in the initial TUR [43].…”

Section: Nmibc With Vh: Critical Issuesmentioning

confidence: 99%

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Non-Muscle Invasive Bladder Cancer with Variant Histology: Biological Features and Clinical Implications

et al. 2021

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Background: The most common bladder cancer (BC) histotype is pure urothelial carcinoma (UC), which may undergo divergent differentiation in some cases. Variant histology (VH) presents along variable morphologies, either single or combined between them or with pure UC. From a clinical standpoint, the vast majority of BC is diagnosed at non-invasive or minimally invasive stages, namely as non-muscle invasive BC (NMIBC). There is a wide range of therapeutic options for patients with NMIBC, according to their clinical and pathological features. However, current risk stratification models do not show optimal effectiveness. Evidence from the literature suggests that VH has peculiar biological features, and may be associated with poorer survival outcomes compared to pure UC. Summary: In order to describe the biological features and prognostic/predictive role of VH in NMIBC, and to discuss current treatment options, we performed a systematic literature search through multiple databases (PubMed/Medline, Google Scholar) for relevant articles according to the following terms, single and/or in combination: “non-muscle invasive bladder cancer,” “variant histology,” “micropapillary variant,” “glandular differentiation,” “squamous differentiation,” “nested variant,” “plasmacytoid variant,” and “sarcomatoid variant.” We extracted 99 studies including original articles, reviews, and systematic reviews, and subsequently analyzed data from 16 studies reporting on the outcome of NMIBC with VH. We found that the relative rarity of these forms as well as the heterogeneity in study populations and therapeutic protocols results in conflicting findings overall. Key Messages: The presence of VH should be taken into account when counseling a patient with NMIBC, since it may upgrade the disease to high-risk tumor and thus warrant a more aggressive treatment.

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Section: Micropapillary Variantsupporting

confidence: 78%

Section: Nmibc With Vh: Critical Issuesmentioning

confidence: 79%

Section: Nmibc With Vh: Critical Issuesmentioning

confidence: 99%

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Non-Muscle Invasive Bladder Cancer with Variant Histology: Biological Features and Clinical Implications

et al. 2021

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“…All other VH subgroups exhibited more aggressive natural history than UCUB in nonmetastatic stages only. 10 …”

Section: Rare Bladder Cancermentioning

confidence: 99%

The 2021 COVID-19 Artificial Intelligence Issue

Hsieh¹

2021

Clinical Genitourinary Cancer

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“…Little is currently known about the prognosis of patients with non‐UC histology in an era when immune checkpoint inhibitors (ICIs) can be used 3 . The treatment strategy for UC has changed dramatically since ICIs were introduced in the field of UC management.…”

mentioning

confidence: 99%

Editorial Comment to Prognostic impact of non‐urothelial carcinoma of the upper urinary tract: Analysis of hospital‐based cancer registry data in Japan

Hayakawa

Kikuchi

2020

Int J of Urology

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Bladder Cancer: A Comparison Between Non-urothelial Variant Histology and Urothelial Carcinoma Across All Stages and Treatment Modalities

Cited by 41 publications

References 22 publications

Non-Muscle Invasive Bladder Cancer with Variant Histology: Biological Features and Clinical Implications

Non-Muscle Invasive Bladder Cancer with Variant Histology: Biological Features and Clinical Implications

The 2021 COVID-19 Artificial Intelligence Issue

Editorial Comment to Prognostic impact of non‐urothelial carcinoma of the upper urinary tract: Analysis of hospital‐based cancer registry data in Japan

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